Predictors of returns to the emergency department after head and neck surgery
| Autor: | Paul Lipori, Gileno Fonseca, Natalie L. Silver, Carolyn O. Dirain, Brian J. Boyce, Jingnan Zhang, Raja Sawhney, R Michael Baskin, Peter T. Dziegielewski |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Logistic regression Patient Readmission law.invention Cohort Studies Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors law Humans Medicine 030212 general & internal medicine Quality of care Aged Retrospective Studies Aged 80 and over Adult patients business.industry Cancer stage Univariate Health Care Costs Emergency department Middle Aged Intensive care unit Otorhinolaryngology Head and Neck Neoplasms Surgical Procedures Operative 030220 oncology & carcinogenesis Emergency medicine Florida Head and neck surgery Female Emergency Service Hospital business |
| Zdroj: | Head & Neck. 40:498-511 |
| ISSN: | 1043-3074 |
| DOI: | 10.1002/hed.25019 |
| Popis: | BACKGROUND Thirty-day hospital readmissions have become a measure of quality of care. Many readmissions enter through the emergency department. The purposes of this study were to determine the rate, risk factors, and costs of 30-day returns to the emergency department (30dEDRs) after head and neck surgery. METHODS All adult patients undergoing head and neck surgery at the University of Florida from 2012 to 2014 were reviewed. Univariate and multivariate logistic regression analyses were performed to identify risk factors for 30dEDRs. RESULTS We found 1065 patients who underwent 1173 procedures. There were 88 cases (7.5%) that resulted in 30dEDRs and 55 patients (4.7%) who had 30-day unplanned readmissions (30dURs). Significant predictors of 30dEDRs included: smoking; hypothyroidism; and intensive care unit (ICU) stays. Significant predictors of readmission from an emergency department visit were Charlson Comorbidity Index (CCI) and cancer stage. Total costs of 30dEDRs and any subsequent readmissions topped $500 000. CONCLUSION The rate of 30dEDRs after head and neck surgery is low; however, these visits increase the hospitals' financial burden as well as patient morbidity. Predictors of 30dEDRs may be utilized to formulate preventative measures. |
| Databáze: | OpenAIRE |
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