Readmission rates after lower extremity bypass vary significantly by surgical indication

Abstract

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.

Risk Factors for 30-Day Hospital Re-Admission with an Infectious Complication after Lower-Extremity Vascular Procedures

“…Lower-extremity bypass procedures are associated with a high rate of unplanned re-admissions [4,10]. We found that among patients re-admitted with an infection, surgical site infection and LE cellulitis were the most common.…”

“…Co-morbidities associated with re-admission and infection in bivariable analysis included a diagnosis of diabetes at the time of the index procedure. Previous investigations have supported this conclusion indirectly by demonstrating a direct association between insulindependent diabetes and a higher risk of 30-d re-admission [4,12,22]. Although the association between diabetes and re-admission is not surprising, it may well represent an association between poor glucose control and an overall higher risk of infection.…”

“…However, there is a gap between identifying risk factors for re-admission, relating them to the cause of re-admission, and, finally, developing changes in practice that would mitigate these risk factors, thus improving the quality of care and decreasing readmissions. Surgical site complications and infections have been described as common diagnoses among surgical readmissions, yet there is little ability to predict who is at greatest risk [4][5][6].…”

Short- and long-term readmission rates after infrainguinal bypass in a safety net hospital are higher than expected

“…6,7 Specifically, vascular surgery patients are known to have high postoperative readmission rates, regardless of the procedure. [8][9][10][11][12][13][14][15][16][17][18][19] This circumstance is particularly true for patients undergoing lower extremity infrainguinal bypass (LEB). [10][11][12][13][14][15] Readmission data identified in previous studies only considered postoperative readmission at 30 days and have been high, ranging from 14% to 24%.…”

Assessment of the Influence of Diabetes mellitus and Malnutrition on the Postoperative Complication Rate and Quality of Life of Patients in a Clinic Focused on Trauma Surgery

“…Furthermore, rising costs and an increased inpatient readmission rate are often consequences of diabetes mellitus [5,22,23]. As published by the International Diabetes Federation (IDF), Germany ranks third among the top 10 countries worldwide in terms of costs and expenses caused by diabetes mellitus in adults (20-79 years) [1,24].…”