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Understanding nationwide readmissions after parotidectomy
Author(s) -
Mukdad Laith,
Goel Alexander N.,
Nasser Hassan B.,
St. John Maie A.
Publication year - 2020
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.28187
Subject(s) - medicine , parotidectomy , odds ratio , comorbidity , confidence interval , incidence (geometry) , retrospective cohort study , logistic regression , emergency medicine , multivariate analysis , surgery , facial nerve , physics , optics
Objectives To evaluate the incidence, causes, risk factors, and costs associated with 30‐day readmissions in parotidectomy patients utilizing the Nationwide Readmissions Database (NRD). Study Design Retrospective cohort study. Methods We examined the NRD for patients who underwent parotidectomy between 2010 and 2014. Rates, causes, and costs of 30‐day readmissions were determined. Multivariate logistic regression was used to identify risk factors for readmission. Results Among 15,102 included patients, 594 (3.9%) were readmitted within 30 days. The average cost per readmission was $12,502. Infectious (22.7%) and wound (11.2%) complications were the two most common causes of readmission. After controlling for other covariates, significant predictors of readmission included advanced comorbidity (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.09–2.37), a malignant parotid tumor (OR, 2.37; 95% CI, 1.63–3.43), length of stay ≥2 days (OR, 1.54; 95% CI, 1.09–2.18), and nonroutine discharge destinations (home with care [OR, 1.88; 95% CI, 1.27–2.78] and nursing facility [OR, 2.69; 95% CI, 1.55–4.67]). Conclusion In this nationwide database analysis, we found that nearly 4% of all patients undergoing parotidectomy are readmitted within 30 days. Readmissions are commonly due to infections and wound complications. Quality improvement proposals targeting avoidable readmissions should focus on early recognition and prevention of infection and wound complications. Risk factors contributing to readmission include advanced comorbidity, malignant parotid tumor, prolonged index hospitalization, and nonroutine discharge destinations. Level of Evidence NA Laryngoscope , 130:1212–1217, 2020