Short- and long-term readmission rates after infrainguinal bypass in a safety net hospital are higher than expected

摘要: Abstract Objective Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, 1 year in a large safety determine magnitude of short- long-term readmission after lower extremity infrainguinal bypass this setting. Methods All nonemergent performed between 2008 2016 were identified. Patient demographic, social, clinical, procedural details extracted from electronic medical record. An analysis patients readmitted was completed readmission. Results A total 350 undergoing The frequent indication tissue loss (57%), followed by claudication (25.6%), rest pain (17.4%). insurance carriers included Medicare (61.7%), Medicaid (25.4%), private (13%). distal target popliteal tibial artery 52.6% 47.4% cases, respectively. majority bypasses used autologous vein (73.1%). In-hospital complications pulmonary (4.3%), urinary tract infection (3.1%), acute renal failure (2%), graft occlusion myocardial infarction (1.7%), bleeding (1.4%), surgical wound (1.1%), stroke (0.9%). 30-day rate 30% with common reasons for being complications, nonsurgical foot/leg wounds, nonextremity infectious causes, cardiac ischemia, congestive heart failure. 90-day 49.4% 31 90 days contralateral leg morbidity. within 72.2%. causes 91 days morbidity, infectious, associated (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.06-2.69; P  = .029) (OR, 1.77; CI, 1.14-2.74, .011) Nonprivate 2.31; 1.17-4.57, .016), critical limb ischemia (OR, 1.77; 1.14-2.74; .035) 1-year Conclusions Short- setting high. study higher than historically reported. This data sets baseline future analyses. Although short-term related index procedure, more frequently systemic comorbidities. Targeted patient interventions aimed preventing improve rates, particularly among nonprivate insurance. However, other risk factors, such as target, not modifiable need accepted population.