Postoperative revisits and readmissions after facelift surgery

Lee, Linda N.; Quatela, Olivia; Bhattacharyya, Neil

doi:10.1002/lary.27220

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…While not all ED visits or admissions within 7 days of surgery are necessarily directly related to the ASC procedure, it would be of interest if cases or controls had an elevated odds of such events, so we therefore defined ED visits with or without a subsequent admission as a revisit. In our previous published work on ASCs, we used this revisit definition as our primary outcome and others have used revisits or ED visits for evaluating surgical outcomes …”

Section: Methodsmentioning

confidence: 99%

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Assessing the Ambulatory Surgery Center Volume-Outcome Association

Jain,

Rosenbaum,

Reiter

et al. 2024

JAMA Surg

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ImportanceIn surgical patients, it is well known that higher hospital procedure volume is associated with better outcomes. To our knowledge, this volume-outcome association has not been studied in ambulatory surgery centers (ASCs) in the US.ObjectiveTo determine if low-volume ASCs have a higher rate of revisits after surgery, particularly among patients with multimorbidity.Design, Setting, and ParticipantsThis matched case-control study used Medicare claims data and analyzed surgeries performed during 2018 and 2019 at ASCs. The study examined 2328 ASCs performing common ambulatory procedures and analyzed 4751 patients with a revisit within 7 days of surgery (defined to be either 1 of 4735 revisits or 1 of 16 deaths without a revisit). These cases were each closely matched to 5 control patients without revisits (23 755 controls). Data were analyzed from January 1, 2018, through December 31, 2019.Main Outcomes and MeasuresSeven-day revisit in patients (cases) compared with the matched patients without the outcome (controls) in ASCs with low volume (less than 50 procedures over 2 years) vs higher volume (50 or more procedures).ResultsPatients at a low-volume ASC had a higher odds of a 7-day revisit vs patients who had their surgery at a higher-volume ASC (odds ratio [OR], 1.21; 95% CI, 1.09-1.36; P = .001). The odds of revisit for patients with multimorbidity were higher at low-volume ASCs when compared with higher-volume ASCs (OR, 1.57; 95% CI, 1.27-1.94; P &lt; .001). Among patients with multimorbidity in low-volume ASCs, for those who underwent orthopedic procedures, the odds of revisit were 84% higher (OR, 1.84; 95% CI, 1.36-2.50; P &lt; .001) vs higher-volume centers, and for those who underwent general surgery or other procedures, the odds of revisit were 36% higher (OR, 1.36; 95% CI, 1.01-1.83; P = .05) vs a higher-volume center. The findings were not statistically significant for patients without multimorbidity.Conclusions and RelevanceIn this observational study, the surgical volume of an ASC was an important indicator of patient outcomes. Older patients with multimorbidity should discuss with their surgeon the optimal location of their care.

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Section: Methodsmentioning

confidence: 99%

“…In our previous published work on ASCs, we used this revisit definition as our primary outcome 18 and others have used revisits or ED visits for evaluating surgical outcomes. [19][20][21][22][23]…”

Section: Defining Patient Outcomesmentioning

confidence: 99%

Assessing the Ambulatory Surgery Center Volume-Outcome Association

Jain,

Rosenbaum,

Reiter

et al. 2024

JAMA Surg

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“…The subject of RV has mostly been analyzed after a day-case otological surgery, sinonasal surgery, and facial surgery. These studies have reported an RV rate ranging between 2.3-5.2% [19][20][21]. Another study found the RV rate after thyroidectomy as 3.6%.…”

Section: Interpretation Within the Context Of The Wider Literaturementioning

confidence: 96%

Analysis of unplanned revisits and readmissions: results of the General Surgery clinic in a private hospital

Narmanlı

Özgüç

Çevikkalp

et al. 2022

The European Research Journal

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Objectives:In recent years, the rate of readmission (RA) within the first thirty days of discharge has been an important parameter for cost and quality standards. It is therefore extremely important for each center to analyze its own results and determine the factors affecting the RA rates in order to organize the measures to be taken. Another important issue, especially for centers focusing on specific areas of expertise, is unplanned revisit (RV) after discharge. Determination of these rates and reasons is of importance for every hospital and/or clinic to decrease these rates, thus increasing patient satisfaction and reducing costs. The aim of this study was to analyze RA and RV patients operated in the general surgery clinic of our hospital for a period of two years as well as factors affecting these rates. Methods: The study included patients who were operated in the general surgery clinic of Bursa Private Medicabil Hospital between 1 January 2018 and 31 December 2019 and who revisited and were readmitted within the first thirty days of discharge. The reasons for RA/RV and time to RA/RV, and patients' treatments were investigated by comparing RA/RV patients with those who were not readmitted (NA) for demographic results at initial admission to determine the differences between these patient groups. Univariate and multivariate analyses were carried out using the SPSS software. The level of significance was set at p < 0.05. Results: Of the 890 patients who were operated in our clinic throughout the study period and met the study inclusion criteria, 52 (5.8%) were included in the unplanned RA group and 107 (12%) in the unplanned RV group. The mean time to RA was 10.5 ± 7.0 days for the RV group and 8.8 ± 6.7 days for the RA group (p = 0.17). Thirty-two (61.5%) of the RA patients and 41 (38.3%) of the RV patients were readmitted within the first 7 days of discharge (p = 0.003). The multivariate analysis revealed that prolonged length of hospital stay, emergency surgery, abnormal WBC, electrolyte imbalance, and abnormal hemoglobin level were significant risk factors for RV, while the development of complications, prolonged length of hospital stay, and advanced age were significant risk factors for RA. Conclusions: This study analyzing the RA and RV patients operated in the general surgery clinic of a private hospital demonstrated that the most important reasons for RA were nonspecific and preventable. Patients who developed complications, had prolonged length of hospital stay, and were at an advanced age had a higher rate of RA, while patients who had prolonged length of hospital stay, underwent emergency surgery, and had biochemical problems at initial admission had a higher rate of RV. Focusing on these patients during and after discharge and increasing home care facilities can solve the problems of many patients without admitting them to the hospital. This will be a factor that would improve patient satisfaction while reducing costs.

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