Vieira Brittany L, Dorfman Robert, Turin Sergey, Gutowski Karol A
Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL. Division of Plastic and Reconstructive Surgery, University of Illinois - Chicago, Chicago, IL.
Aesthet Surg J. 2017 Sep 1;37(8):917-926. doi: 10.1093/asj/sjx012.
Hospital readmissions can be a major contributor to increased healthcare costs and are a salient current topic in healthcare. There is a paucity of large, prospective studies that evaluate rates and risk factors of readmission within the aesthetic subset of plastic surgery.
The authors propose to determine the rates of unplanned readmission following body contouring procedures and to analyze the predictors associated with it.
The 2011 and 2012 National Surgical Quality Improvement Program Database was queried for body contouring procedures using the appropriate Current Procedural Terminology codes. The rate of unplanned readmission, preoperative risk factors, comorbidities, and medical and surgical postoperative complications data were analyzed using multivariate regression models to determine predictors of readmission after these procedures.
We identified 5100 patients who underwent body contouring procedures, of which 142 (2.8%) experienced an unplanned readmission. Forty-eight per cent of readmitted patients experienced at least one surgical complication, and 23.9% experienced at least one medical complication. Multivariate regression analyses identified several independent predictors of unplanned readmission: increasing age (odds ratio [OR] 1.018 per year, P = 0.039), bleeding disorders (OR 3.674, P = 0.039), increased operative time (each additional hour conferring a 20% increased risk), surgical complications (OR 19.179, P < 0.001), and medical complications (OR 10.240, P < 0.001).
The unplanned readmission rate for body contouring procedures is low overall (2.8%). We identified age, bleeding disorders, operative duration, and postoperative complication as independent risk factors for unplanned readmission. These data can help guide preoperative risk stratification and future interventions in high-risk patient populations.
医院再入院可能是医疗费用增加的主要原因，也是当前医疗领域的一个突出话题。在整形手术的美容亚组中，评估再入院率和风险因素的大型前瞻性研究较少。
作者旨在确定身体塑形手术后计划外再入院的发生率，并分析与之相关的预测因素。
使用适当的当前手术操作术语代码，查询2011年和2012年国家外科质量改进计划数据库中的身体塑形手术。使用多变量回归模型分析计划外再入院率、术前风险因素、合并症以及医疗和手术术后并发症数据，以确定这些手术后再入院的预测因素。
我们确定了5100例行身体塑形手术的患者，其中142例（2.8%）经历了计划外再入院。48%的再入院患者至少经历了一种手术并发症，23.9%的患者至少经历了一种医疗并发症。多变量回归分析确定了几个计划外再入院的独立预测因素：年龄增加（每年的优势比[OR]为1.018，P = 0.039）、出血性疾病（OR 3.674，P = 0.039）、手术时间延长（每增加一小时风险增加20%）、手术并发症（OR 19.179，P < 0.001）和医疗并发症（OR 10.240，P < 0.001）。
总体而言，身体塑形手术的计划外再入院率较低（2.8%）。我们确定年龄、出血性疾病、手术持续时间和术后并发症是计划外再入院的独立风险因素。这些数据有助于指导术前风险分层以及对高危患者群体的未来干预。
2级。
