30-day hospital readmission following otolaryngology surgery: Analysis of a state inpatient database

Evan M. Graboyes, Dorina Kallogjeri, Mohammed J. Saeed, Margaret A. Olsen, Brian Nussenbaum

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Objectives/Hypothesis: Determine patient and hospital-level risk factors associated with 30-day readmission for patients undergoing inpatient otolaryngologic surgery. Study Design: Retrospective cohort study. Methods: We analyzed the State Inpatient Database (SID) from California for patients who underwent otolaryngologic surgery between 2008 and 2010. Readmission rates, readmission diagnoses, and patient- and hospital-level risk factors for 30-day readmission were determined. Hierarchical logistic regression modeling was performed to identify procedure-, patient-, and hospital-level risk factors for 30-day readmission. Results: The 30-day readmission rate following an inpatient otolaryngology procedure was 8.1%. The most common readmission diagnoses were nutrition, metabolic, or electrolyte problems (44% of readmissions) and surgical complications (10% of readmissions). New complications after discharge were the major drivers of readmission. Variables associated with 30-day readmission in hierarchical logistic regression modeling were: type of otolaryngologic procedure, Medicare or Medicaid health insurance, chronic anemia, chronic lung disease, chronic renal failure, index admission via the emergency department, in-hospital complication during the index admission, and discharge destination other than home. Conclusion: Approximately one out of 12 patients undergoing otolaryngologic surgery had a 30-day readmission. Readmissions occur across a variety of types of procedures and hospitals. Most of the variability was driven by patient-specific factors, not structural hospital characteristics. Level of Evidence: 4. Laryngoscope, 2016 127:337–345, 2017.

Original languageEnglish
Pages (from-to)337-345
Number of pages9
JournalLaryngoscope
Volume127
Issue number2
DOIs
StatePublished - Feb 1 2017

Keywords

  • Readmissions
  • complications
  • otolaryngology
  • quality
  • state inpatient database

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