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

30-day hospital readmission following otolaryngology surgery: Analysis of a state inpatient database.
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Graboyes EM, Kallogjeri D, Saeed MJ, Olsen MA, Nussenbaum B,


Graboyes EM, Kallogjeri D, Saeed MJ, Olsen MA, Nussenbaum B, (click to view)

Graboyes EM, Kallogjeri D, Saeed MJ, Olsen MA, Nussenbaum B,

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The Laryngoscope 2016 04 21127(2) 337-345 doi 10.1002/lary.25997
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.

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