Predictors of 30- and 90-Day Readmissions After Complex Abdominal Wall Reconstruction With Biological Mesh: A Longitudin
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ORIGINAL SCIENTIFIC REPORT
Predictors of 30- and 90-Day Readmissions After Complex Abdominal Wall Reconstruction With Biological Mesh: A Longitudinal Study of 232 Patients Shekhar Gogna1 • Rifat Latifi2 • James Choi1 • Jorge Con3 • Kartik Prabhakaran4 Abbas Smiley5 • Patrice L. Anderson6
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Accepted: 18 July 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Hospital readmissions are recognized as indicators of poor healthcare services which further increase patient morbidity. The aim of this study is to analyze predicting factors for the 30-day and 90-day readmissions after a complex abdominal wall reconstruction (CAWR). Methods A pooled analysis of the prospective study and retrospective database patients undergoing CAWR with acellular porcine dermis from 2012 to 2019 was carried out. Independent t test for continuous variables and Chisquare and Fischer’s exact tests for categorical variables were used. A multivariable logistic regression model and linear regression analysis were used to analyze the independent predictors of 30-day and 90-day readmissions. Results A total of 232 patients underwent CAWR, and the readmission rate (RR) was 16.8% (n = 40). The 30-day and 90-day RR was 11.3% (n = 23) and 13.3% (n = 33), respectively. There were no statistical differences in age, frailty, and gender distribution between the two groups. There was no difference in ASA score, type of component separation, ventral hernia working group class, size of the biological mesh, placement of mesh, and intestinal resection rate. The Clavien–Dindo complications and mean comprehensive complication index (CCI) were higher in the readmission group as compared to no readmission group (p \ 0.01). Readmitted patients had higher surgical site infections (p \ 0.01) and wound necrosis (p = 0.01). Higher CCI, past or concomitant pelvic surgery, and the presence of enterocutaneous fistula were independent predictors of earlier days to readmission. Conclusion Surgical site occurrences were associated with 30-day and 90-day readmissions after CAWR, while the presence of ascites and dialysis was associated with 90-day readmissions.
& Rifat Latifi [email protected] Shekhar Gogna [email protected] James Choi [email protected]
Patrice L. Anderson [email protected] 1
Department of Surgery, Westchester Medical Center, New York Medical College, 100 Woods Road, Taylor Pavilion, Office Suite #353, Valhalla, NY 10595, USA
2
Department of Surgery, School of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA
3
Trauma and Critical Care, Department of Surgery, Westchester Medical Center, New York Medical College, 100 Woods Road, Taylor Pavilion E-131, Valhalla, NY 10595, USA
Jorge Con [email protected] Kartik Prabhakaran [email protected] Abbas Smiley [email protected]
123
World J Surg
Introduction Hospital readmissions after surgery are considered a quality measure of healthcare services provided [1]. Unplanned hospital readmis
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