Drivers of readmissions in vascular surgery patients

摘要: Objective Postoperative readmissions are frequent in vascular surgery patients, but it is not clear which factors the main drivers of readmissions. Specifically, relative contributions patient comorbidities vs those operative and postoperative complications unknown. We sought to study multiple potential readmission create a model for predicting risk patients. Methods The 2012-2013 American College Surgeons National Surgical Quality Improvement Program data set was queried unplanned 86,238 Multivariable forward selection logistic regression analysis used comorbidities, factors, readmission. Results rate 9.3%. preoperative based on demographics predicted with low C index .67; top five predictors were Society Anesthesiologists class, open wound, inpatient operation, dialysis dependence, diabetes mellitus. using better (C index, .78); most significant predictor readmission, overpowering comorbidities. Importantly, identified before discharge from hospital strong as predischarge had similar our (.68). However, inclusion after appreciably improved predictive power .78). final postdischarge deep space infection, superficial surgical site pneumonia, myocardial sepsis. Conclusions Readmissions patients mainly driven by discharge. Thus, efforts reduce focusing may prove ineffective. Our suggests that interventions should focus prompt identification modifiable complications.