Approximately 20% of patients who underwent reconstruction surgery for head and neck cancer were readmitted to the hospital within 30 days of surgery, according to a new study.1
Those patients with lower socioeconomic status, complex ablative procedures, or with a many comorbidities were more likely to be readmitted.
“Avoidable readmissions are estimated to cost the Center for Medicare & Medicaid Services up to $17 billion annually, with nearly 18% of patients requiring readmission within 30 days of discharge,” the researchers wrote. “Identifying the incidence, causes, and risk factors for readmission is an important step toward developing interventions to prevent or mitigate these costly occurrences.”
The retrospective study looked at medical records from the Nationwide Readmissions Database on 9487 patients with head and neck cancer who underwent pedicled or free flat reconstruction between January 2010 and December 2015.
The 30-day readmission rate among patients was 19.4%, with each readmission costing an average of more than $15,000. The total aggregate cost for all 30-day readmissions included in the study was $29.27 million.
Data indicated the most common reason for early hospital readmission was wound complications, which occurred in 26.5% of readmissions for this cancer type. However, other medical diagnoses were more common in late readmissions.
A multivariate regression analysis showed that patients in the lowest quartile of household income were at a nearly 60% increased risk for readmission (odds ratio [OR], 1.58; 95% CI, 1.18-2.11). Other risk factors included congestive heart failure (OR, 1.68), liver disease (OR, 2.02), total laryngectomy (OR, 1.40), pharyngectomy (OR, 1.47), blood transfusion (OR, 1.30), discharge to home with home health care (OR, 1.32), and discharge to a nursing facility (OR, 1.77).
- Goel AN, Raghavan G, St John MA, et al. Risk factors, causes, and costs of hospital readmission after head and neck cancer surgery reconstruction [published online November 8, 2018]. JAMA Facial Plast Surg. doi: 10.1001/jamafacial.2018.1197