Risk factors for 30-day readmission after adrenalectomy

Beck, Anna; Goffredo, Paolo; Hassan, Iffat; Sugg, Sonia L.; Lal, Geeta; Howe, James R.; Weigel, Ronald J.

doi:10.1016/j.surg.2018.04.041

Cited by 15 publications

(14 citation statements)

References 25 publications

(41 reference statements)

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“…Readmissions represent a significant burden to the health care system (9). High readmission rates correlate with decreased quality of care, decreased patient well-being, and increased hospital costs (10,11).…”

Section: Introductionmentioning

confidence: 99%

National perspective on hospital readmissions following adrenalectomy

Hussein¹,

Toraih²,

Fouad³

et al. 2022

Gland Surg

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Background: Examining risk factors of readmission in adrenalectomy patients and estimated the cost burden of unplanned readmission on the United States' healthcare system.Methods: According to the Nationwide Readmission Database, 20,494 patients underwent adrenalectomy between 2010-2014. Demographics, comorbidities, clinical data, length of stay (LOS), annual case volume, and discharge disposition of 30-and 90-day readmission cohorts were compared to the non-readmitted cohort.Results: A total of 1,463 (7.9%) and 1,959 (12.7%) adrenalectomy patients were readmitted at 30 and 90 days after discharge, respectively. Prolonged initial hospital stays [odds ratio (OR) =1.93; 95% confidence interval (CI): 1.63-2.27] and postoperative complications (OR =4.91; 95% CI: 1.98-12.16) were associated with a higher risk of readmission. Complications were significantly more frequent in patients with a primary or secondary malignancy (OR =1.42; 95% CI: 1.23-1.64) and in patients undergoing a procedure at a low adrenalectomy volume hospital [hazard ratio (HR) =0.75; 95% CI: 0.62-0.91; P=0.003]. Readmission extended overall LOS by an average of 2.06 days, costing an additional $18,529.49 per admission.Conclusions: Readmission adds significantly to the burden of disease after adrenalectomy. Understanding contributing factors may identify strategies to reduce readmissions and improve healthcare for patients.

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Section: Introductionmentioning

confidence: 99%

National perspective on hospital readmissions following adrenalectomy

Hussein¹,

Toraih²,

Fouad³

et al. 2022

Gland Surg

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“…RLA has been widely used in clinical practice, but it is prone to wound infection, bleeding, and even shock during postoperative care [22]. Dressings are considered to be an important method to promote wound healing and prevent bacterial infections [23].…”

Section: Discussionmentioning

confidence: 99%

Nursing Effect of Zinc Oxide Nanoantibacterial Materials after Adrenalectomy

Yang

Liu

Fan

2022

Journal of Nanomaterials

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Laparoscopic adrenalectomy (RLA) is widely used for adrenal tumors, cancer, cortical hyperplasia, etc. Therefore, how to care for patients after surgery is a necessary means to speed up the rapid healing of surgical wounds and reduce the incidence of related complications. To solve the problem in traditional wound treatment, antibacterial dressings are used, and most of the auxiliary materials need to be replaced frequently, or there is serious adhesion to the wound, which causes secondary wound infection. The methods used to study in this work report a new long-acting antibacterial and breathable wound dressing based on nanoscale zinc oxide nanoparticles (ZnO NPs) in the care of adrenalectomy; the clinical effects of ZnO NP-based antibacterial dressings were systematically evaluated in terms of patients’ wound healing rate (%), infection rate (%), healing time (d), and the number of dressing changes. The results revealed that the wound healing rate of patients with ZnO NP-based antibacterial dressing was as high as 16.67% and the incidence of adverse reactions was only 26.19%, which was 40.48% lower than traditional dressings. Such promising antibacterial dressings are expected to be greatly used in the medical field in the future.

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“…This rate is between 5% and 15% after abdominal surgery 41 . Beck et al reported the readmission risk factors after adrenalectomy as high ASA score, diabetes, advanced age, primary adrenal cancer surgery, long operation time, operation type and postoperative complications 47 . In our series, readmission was 9.1% in the open approach and 3.4% in the laparoscopic approach and this was not statistically significant(p=0.297,p<0.05).Reasons for readmission were hypotension and pleural effusion in the open surgical approach group, and pancreatic fistula and wound infection in the area where the specimen was removed in the laparoscopic approach group.The limitations of our study were its' retrospective nature, limited number of patients and being conducted in a single center.…”

Section: Discussionmentioning

confidence: 99%

Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması

Dalcı

Topal

Ünal

et al. 2019

Cukurova Medical Journal

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The aim of this study was to compare the results of conventional and laparoscopic adrenalectomy in adrenal mass cases operated on during a 9-year period. Materials and Methods: A total of 81 patients who underwent adrenalectomy were included in the study. Patients were divided into two groups as; Group 1conventional surgery and Group 2-laparoscopic surgery. Two groups were compared retrospectively on characteristics such as; age, sex, body mass index (BMI), American Society of Anesthesiologists' score (ASA), mass localization, mass size and hormonal activity of the mass, duration of operation, amount of bleeding in operation, duration of hospitalization, duration until food intake, perioperative mortality, early complications and readmission to hospital within 90 days. Results: There were 22 patients in Group 1 and 59 patients in Group 2. No statistically significant difference was found between the groups in terms of age, sex, BMI, ASA score, tumor localization, indications for operation, postoperative complication, perioperative mortality and re-admittance within 90 days. The hormonal activity of the mass was higher and the mass was smaller in size in Group 2. The duration of operation (min), the amount of bleeding in the operation (ml), the duration until oral intake (days) and the length of hospital stay (days) were found to be statistically significantly higher in Group 1. Conclusion: Laparoscopic adrenalectomy should be the preferred surgical method because of its short duration of operation, low blood loss, early onset of oral food intake and shorter hospital stay, as well as its safety. Amaç: Bu çalışmada, 9 yıl içerisinde adrenal kitle nedeni ile ameliyat edilen olgularda konvansiyonel ve laparoskopik adrenalektominin sonuçlarının karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Adrenalektomi uygulanan 81 hasta çalışmaya dahil edildi. Grup 1 konvansiyonel, Grup 2 Laparaskopik cerrahi olarak hastalar iki grupa ayrıldı. İki grup, yaş, cinsiyet, vücut kitle indeksi (VKİ), Amerikan anestezistler derneği skoru (ASA), kitle lokalizasyonu, kitle büyüklüğü ve kitlenin hormonal aktivitesi, operasyon süresi, operasyonda kanama miktarı, yatış süresi, gıdaya başlama süresi, perioperatif mortalite, erken dönem komplikasyonlar ve 90 gün içinde hastaneye tekrar başvuru gibi özellikleri esas alınarak retrospektif olarak karşılaştırıldı. Bulgular: Grup 1'de 22, Grup 2'de 59 hasta mevcut idi. Gruplar arasında yaş, cinsiyet, VKİ, ASA skoru, tümör lokalizasyonu, operasyon endikasyonları, postoperatif komplikasyon, perioperatif mortalite ve 90 gün içinde tekrar başvuru açısından istatistiksel olarak anlamlı fark saptanmadı. Kitlenin hormonal aktivitesi Grup 2'de daha yüksek, boyutu ise daha küçük saptandı. Operasyon süresi (dak), ameliyatta kanama miktarı (ml), oral alım süresi (gün) ve hastanede yatış süresi (gün) Grup 1'de daha fazla ve istatiksel olarak anlamlı bulundu. Sonuç: Laparoskopik adrenalektomi uygun hastalarda, kısa operasyon süresi, az kan kaybı, oral gıdaya erken başlama süresi ve daha kısa hastanede kalış sü...

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Risk factors for 30-day readmission after adrenalectomy

Abstract: Encouraging the appropriate use of laparoscopic adrenalectomy, preventing venous thrombotic events and surgical infections, and improving early post-operative follow-up in high-risk patients may decrease readmissions.

Cited by 15 publications

References 25 publications

National perspective on hospital readmissions following adrenalectomy

National perspective on hospital readmissions following adrenalectomy

Nursing Effect of Zinc Oxide Nanoantibacterial Materials after Adrenalectomy

Adrenal kitlelerde laparaskopik ve açık cerrahi tekniklerin sonuç açısından karşılaştırılması

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