Head and neck microvascular free flap reconstruction: An analysis of unplanned readmissions.
Research article published in The Laryngoscope (2016)
Abstract
OBJECTIVES/HYPOTHESIS: Unplanned readmissions within 30 days of surgery represent a significant marker for healthcare quality. Small institutional studies have described rates of readmission for patients undergoing head and neck free flap reconstruction. However, large, multi-institutional analyses have not previously been described. STUDY DESIGN: Retrospective study of cases from the American College of Surgeons National Surgical Quality Improvement Program database. METHODS: Patients who underwent free flap reconstruction of the head and neck from 2011 to 2013 were identified. Univariate and multivariate analyses of unplanned readmission based on patient, laboratory, and hospital course characteristics were conducted. RESULTS: In total, 1,238 patients who underwent head and neck microvascular free flap reconstruction were included within the database, of which 1,204 patients had information pertaining to readmission. Overall 30-day readmission rate was 9.6%. A multivariate analysis of preoperative variables demonstrated that leukocytosis, diabetes mellitus, and hyponatremia were all associated with increased rates of readmission (odds ratio 2.224, 1.843, and 1.7423, respectively). A similar analysis of postoperative variables demonstrated that wound-related complications (surgical site infections and wound disruption), perioperative blood transfusion, and sepsis were associated with an increased rate of readmission. CONCLUSION: In patients with microvascular free flap reconstruction of the head and neck, the 30-day readmission rate was 9.6%. Preoperative diabetes mellitus, hyponatremia, and leukocytosis were associated with an increased rate of 30-day readmissions. Postoperative complications, particularly wound infections, perioperative blood transfusions, and sepsis, were found to be significant contributors to readmission. LEVEL OF EVIDENCE: 4. Laryngoscope, 2016 127:325-330, 2017.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Unplanned readmissions within 30 days of surgery represent a significant marker for healthcare quality. Small institutional studies have described rates of readmission for patients undergoing head and neck free flap reconstruction.
Почему это важно для гирудотерапии
This study analyzed unplanned 30-day readmissions following head and neck microvascular free flap reconstruction using data from 1,238 patients in the American College of Surgeons National Surgical Quality Improvement Program database (2011–2013), reporting an overall 30-day readmission rate of 9.6%. Multivariate analyses identified preoperative leukocytosis, diabetes mellitus, and hyponatremia as well as postoperative wound-related complications, perioperative blood transfusion, and sepsis as significant contributors to readmission. The abstract does not mention leeches, hirudotherapy, venous congestion, or any connection to the leech secretome. There is no defensible leech link in this article.
Цитирование
Head and neck microvascular free flap reconstruction: An analysis of unplanned readmissions.
Carniol et al. · The Laryngoscope, 2016
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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