1. Thirty-day hospital readmission and emergency department visits after vascular surgery: a Canadian prospective cohort study
- Author
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Syed, Muzammil H., Hussain, Mohamad A., Khoshhal, Zeyad, Salata, Konrad, Altuwaijri, Beidaa, Hughes, Bertha, Alsaif, Norah, de Mestral, Charles, Verma, Subodh, and Al-Omran, Mohammed
- Subjects
Hospitalization -- Demographic aspects ,Emergency medical services -- Demographic aspects ,Postoperative complications -- Care and treatment ,Medical care quality -- Management ,Vascular surgery -- Complications and side effects -- Patient outcomes ,Company business management ,Health ,Health care industry - Abstract
Background: Rates of hospital readmission following surgery can serve as a marker for quality of care. The aim of this study was to establish the rates and causes of readmission and emergency department visits after vascular surgery and to understand how these patients are managed. Methods: We conducted a prospective observational cohort study including all in patients who underwent major vascular surgery between September 2015 and June 2016 at a tertiary vascular care centre in Toronto. Patients were followed at 30 days after discharge via telephone interview. Results: We enrolled 133 patients (94 men [70.7%] and 39 women [29.3%] with a mean age of 65.3 years). The most common index admission diagnosis was peripheral artery disease (67 patients [50.4%]). At 30 days, 19 patients (14.8%) had been readmitted or had visited the emergency department, most commonly after lower extremity revascularization (19.4%). Ten patients were readmitted a mean of 16.8 days following discharge; surgical site infection was the most common cause for readmission (3 patients). The most common treatment was antimicrobial therapy (4 patients). The mean hospital length of stay was 14.4 days. Nine patients presented to the emergency department a mean of 10.6 days after discharge; 6 reported a wound issue, and most (6 of 9) were managed with oral antibiotic treatment. Conclusion: Early readmission/emergency department visits after lower extremity revascularization surgery in patients with peripheral artery disease are common and are often due to surgical site infection or wound-related issues. Follow-up within 7-10 days and a specialized wound care team may help reduce the occurrence of these events. Contexte : Les taux de readmission a l'hopital apres une chirurgie peuvent servir d'indicateur de la qualite des soins. L'etude visait a determiner les taux et les causes de readmissions et de visites a l'urgence chez les patients ayant subi une chirurgie vasculaire et a etudier la facon dont ces patients etaient pris en charge. Methodes : Nous avons mene une etude de cohorte observationnelle prospective portant sur tous les patients qui ont ete hospitalises pour une importante chirurgie vasculaire entre septembre 2015 et juin 2016 dans un centre de soins tertiaires vasculaires a Toronto. Nous avons fait un suivi telephonique aupres de ces patients 30 jours apres leur conge. Resultats : Nous avons recrute 133 patients (94 hommes [70,7 %] et 39 femmes [29,3 %] dont l'age moyen etait de 65,3 ans). Le diagnostic le plus courant a l'admission initiale etait la maladie arterielle peripherique (67 patients [50,4 %]). A 30 jours, 19 patients (14,8 %) avaient ete rehospitalises ou s'etaient presentes a l'urgence; la plupart avaient initialement subi une revascularisation des membres inferieurs (19,4 %). Dix patients ont ete rehospitalises en moyenne 16,8 jours apres leur conge; l'infection du site operatoire etait la cause la plus courante de readmission (3 patients). Le traitement le plus courant chez les patients rehospitalises etait le traite ment antimicrobien (4 patients). La duree mediane des sejours a l'hopital etait de 14,4 jours. Neuf patients se sont presentes a l'urgence en moyenne 10,6 jours apres leur conge; 6 ont signale un probleme avec leur plaie, et la majorite (6 des 9 patients) ont recu une antibiotherapie orale. Conclusion : Les readmissions ou les visites a l'urgence de patients atteints d'une maladie arterielle peripherique peu apres une chirurgie de revascularisation des membres inferieurs sont courantes et souvent attribuables a une infection du site operatoire ou a des problemes associes a la plaie. Un suivi apres 7 a 10 jours ainsi que les services d'une equipe specialisee en soin des plaies pourraient contribuer a reduire la frequence de ce type d'evenement., Hospital readmission following major surgery is common and expensive and can serve as a marker for quality of care provided. In 2004, nearly 1 in 5 Medicare beneficiaries were readmitted [...]
- Published
- 2018
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