The study is a retrospective review of readmissions in a high-volume, quaternary care center. Post-operative neck infection and bleeding were the most common reasons for unplanned readmission and are high-value targets in ongoing efforts to mitigate hospital readmission.
Objectives
To identify common reasons for readmission following otolaryngologic surgery at a high-volume center and identify possible risk factors for readmission.
Methods
Retrospective chart review of readmissions identified by hospital-based electronic medical record reporting mechanism.
Results
From January 2019 to September 2020, there were 87 readmissions following 808 index surgeries. The most common reason for readmission was for planned surgery (23%), followed by post-operative neck infection, bleeding, or pneumonia. Patients with unplanned readmissions had significantly longer index admission duration than patients who were not readmitted (median 7 days vs. median 5 days, resp.; p = 0.0056). Analysis of cases of unplanned readmission for neck infection and bleeding identified the oral cavity/pharynx as the most common site of initial surgery and that a majority of patients had a history of radiation therapy.
Conclusion
Neck infection, bleeding, and pneumonia were the most common reasons for unplanned readmission following otolaryngologic surgery, and a large portion of patients required additional procedures during readmission. Unplanned readmissions for bleeding were significantly more costly than readmissions for neck infections. Long-index hospitalizations, index surgery involving the oral cavity and pharynx, and a history of radiation therapy may be useful clinical features that could stratify the risk of readmission.
Level of Evidence
Level 4, retrospective chart review Laryngoscope, 2023
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