Predictors and consequences of unplanned hospital readmission within 30 days of carotid endarterectomy

摘要: Objective In the United States, vascular surgeons frequently perform carotid endarterectomy (CEA). Given resource burden of unplanned readmission (URA), we sought to identify predictors and consequences URA after this common surgery procedure potential points intervention. Methods Using a prospective single-institution database, retrospectively identified consecutive patients undergoing CEA (2001-2011). Demographic perioperative factors were prospectively collected. The primary end point was 30-day postdischarge CEA. secondary 1-year survival. We performed univariable analysis for followed by multivariable Cox model. A Kaplan-Meier Results During study period, 840 underwent 897 CEAs. overall rate 8.6% 6.5%, respectively. Most (n = 42; 73.4%) readmitted CEA-related reason (headache, cardiac, hypertension, surgical site infection, bleeding/hematoma, stroke/transient ischemic attack, dysphagia, or hyperperfusion syndrome). Seventeen (29.3%) had more than one URA. Median time 4 days (interquartile range, 1-9 days). Postoperative length stay, indication CEA, discharge destination not associated with analysis, in-hospital occurrence congestive heart failure (hazard ratio [HR], 15.1; 95% confidence interval [CI], 4.7-48.8; P  = .003), prior coronary artery bypass grafting (HR, 2.0; CI, 1.2-3.5; .01) significantly Patients in group also decreased survival during 1 year (91% vs 96%; .01, log-rank). Conclusions is low (6.5%). Prior postoperative stroke, those at increased risk URA, signals long-term mortality.