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Readmission rates after lower extremity bypass vary significantly by surgical indication
- Source :
- Journal of vascular surgery. 64(2)
- Publication Year :
- 2015
-
Abstract
- Objective Readmission rates after vascular surgery are among the highest within surgical specialties, and lower extremity bypass has the highest readmission rate of vascular surgery procedures. We analyzed how 30-day readmissions and risk factors for readmissions vary by indication for lower extremity bypass. Methods We queried the 2012-2014 American College of Surgeons National Surgical Quality Improvement Program procedure-targeted vascular cohort to identify all patients who underwent lower extremity bypass. Emergent procedures and planned readmissions were excluded. Patients were stratified by surgical indication: claudication, critical limb ischemia rest pain (CLI RP), critical limb ischemia tissue loss (CLI TL), and other. The χ 2 and Wilcoxon rank sum tests were used to test the differences between categorical and continuous variables, respectively. Logistic regression was used to estimate odds ratios for predictors of readmission adjusted for preoperative factors that were selected a priori. Results The overall 30-day readmission rate among the 6112 patients who underwent lower extremity bypass was 14.8%. Readmission rates varied significantly on the basis of the indication for surgery. In unadjusted comparisons, 18.8% of patients with CLI TL were readmitted compared with 16.5% with CLI RP, 9.4% with claudication, and 8.2% with other indications ( P Conclusions The 30-day readmission rates after lower extremity bypass vary significantly by surgical indication. Because lower extremity bypasses are performed for multiple indications, if readmission rates are publically reported and hospitals can be penalized for higher than expected readmission rates, the expected readmission rates should be adjusted for surgical indication.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Databases, Factual
Critical Illness
030204 cardiovascular system & hematology
Logistic regression
Patient Readmission
Statistics, Nonparametric
Veins
03 medical and health sciences
Blood Vessel Prosthesis Implantation
Peripheral Arterial Disease
0302 clinical medicine
Postoperative Complications
Ischemia
Risk Factors
medicine
Odds Ratio
Humans
030212 general & internal medicine
Aged
Quality Indicators, Health Care
Aged, 80 and over
Surgeons
Chi-Square Distribution
business.industry
Odds ratio
Critical limb ischemia
Vascular surgery
Intermittent Claudication
Middle Aged
United States
Surgery
Logistic Models
Treatment Outcome
Lower Extremity
Cohort
Observational study
Female
Clinical Competence
medicine.symptom
Cardiology and Cardiovascular Medicine
Claudication
business
Chi-squared distribution
Specialization
Subjects
Details
- ISSN :
- 10976809
- Volume :
- 64
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of vascular surgery
- Accession number :
- edsair.doi.dedup.....34327f2f2d5eea7d1ddbea38374f44be