A closer look at 30 day hospital readmissions after head and neck cancer surgery. Am J Otolaryngol 2021;42(5):103146
Date
06/26/2021Pubmed ID
34171529DOI
10.1016/j.amjoto.2021.103146Scopus ID
2-s2.0-85108366965 (requires institutional sign-in at Scopus site) 1 CitationAbstract
PURPOSE: 30-day hospital readmissions after head and neck cancer surgery continue to be a significant source of patient harm and healthcare expenditure. While there is substantial data in the literature assessing predictive factors for readmissions after head and neck cancer surgery, there are a paucity of studies which attempt to understand if such readmissions are preventable. The goal of this paper is to determine factors associated with 30-day hospital readmissions after head and neck cancer surgery and to understand if these readmissions were preventable.
MATERIALS AND METHODS: Retrospective review from a single academic tertiary care center. Patients readmitted within 30 days after undergoing surgery for cancers of the head and neck between 2015 and 2018 were identified.
RESULTS: Over a 3-year period, 26 patients undergoing resection with or without reconstruction of head and neck cancers were readmitted to the hospital within 30 days of discharge. There were 15 (58%) men and 11 (42%) women with a mean age of 68 years (SD 14 years). Twenty-one (81%) patients had squamous cell carcinoma and 13 (50%) had a primary site in the oral cavity. Thirteen (50%) had undergone free or regional flap reconstruction. The indication for readmission was related to the surgical wound in 19 (73%) and to medical complications in 7 (27%). Each case was categorized as "possibly preventable" versus "uncertain if preventable" based on whether a reasonable and feasible change in management may have prevented readmission. Six (23%) readmissions were deemed possibly preventable. Four were related to the surgical wound where initial free or regional flaps may have prevented complication. Two were medical complications that may have benefited from longer inpatient observation.
CONCLUSIONS: For a subset of patients readmitted within 30 days of head and neck cancer surgery, a reasonable and feasible change in management may have prevented their hospital readmission. The significance of better understanding this patient population is underscored by the high mortality rate.
Author List
Puccia R, Ramamurthi A, Grond SE, McCormick C, Ng A, Stadler M, Massey B, Campbell B, Shukla M, Awan M, Schultz C, Wong S, Shreenivas A, Zenga JAuthors
Becky Massey MD Associate Professor in the Otolaryngology department at Medical College of WisconsinJoseph Zenga MD Assistant Professor in the Otolaryngology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Female
Forecasting
Head and Neck Neoplasms
Health Expenditures
Humans
Male
Middle Aged
Monitoring, Physiologic
Patient Readmission
Postoperative Complications
Surgical Flaps
Surgical Wound Infection
