Head and Neck

Readmission after surgery for oropharyngeal cancer: An analysis of rates, causes, and risk factors

Corresponding Author

Alexander N. Goel BA

[email protected]

orcid.org/0000-0002-9573-0318

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Send correspondence to Alexander N. Goel, Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS 62-237, Los Angeles, CA 90095. E-mail: [email protected]Search for more papers by this author

Karam W. Badran MD,

Karam W. Badran MD

orcid.org/0000-0003-2140-3602

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

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Abie H. Mendelsohn MD,

Abie H. Mendelsohn MD

orcid.org/0000-0001-8895-0286

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California

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Dinesh K. Chhetri MD,

Dinesh K. Chhetri MD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

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Joel A. Sercarz MD,

Joel A. Sercarz MD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

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Keith E. Blackwell MD,

Keith E. Blackwell MD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

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Maie A. St. John MD, PhD,

Maie A. St. John MD, PhD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California

UCLA Head and Neck Cancer Program, UCLA Medical Center, Los Angeles, California

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Jennifer L. Long MD, PhD,

Jennifer L. Long MD, PhD

orcid.org/0000-0002-4185-2328

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Research Service, Department of Veterans Affairs, Los Angeles, California

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Alexander N. Goel BA,

Corresponding Author

Alexander N. Goel BA

[email protected]

orcid.org/0000-0002-9573-0318

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Karam W. Badran MD,

Karam W. Badran MD

orcid.org/0000-0003-2140-3602

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Search for more papers by this author

Abie H. Mendelsohn MD,

Abie H. Mendelsohn MD

orcid.org/0000-0001-8895-0286

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California

Search for more papers by this author

Dinesh K. Chhetri MD,

Dinesh K. Chhetri MD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Search for more papers by this author

Joel A. Sercarz MD,

Joel A. Sercarz MD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

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Keith E. Blackwell MD,

Keith E. Blackwell MD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Search for more papers by this author

Maie A. St. John MD, PhD,

Maie A. St. John MD, PhD

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California

UCLA Head and Neck Cancer Program, UCLA Medical Center, Los Angeles, California

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Jennifer L. Long MD, PhD,

Jennifer L. Long MD, PhD

orcid.org/0000-0002-4185-2328

Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California

Research Service, Department of Veterans Affairs, Los Angeles, California

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First published: 19 September 2018

https://doi.org/10.1002/lary.27461

Citations: 12

Editor's Note: This Manuscript was received on January 22, 2018, revised on February 27, 2018, April 3, 2018, May 7, 2018, May 23, 2018, and June 24, 2018, and accepted for publication on July 2, 2018.

This work was supported by the Dean's Leadership in Health and Science Scholarship at David Geffen School of Medicine (a.n.g.).

The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

Determine the rate, diagnoses, and risk factors associated with 30-day nonelective readmissions for patients undergoing surgery for oropharyngeal cancer.

Study Design

Retrospective cohort study.

Methods

We analyzed the Nationwide Readmissions Database for patients who underwent oropharyngeal cancer surgery between 2010 and 2014. Rates and causes of 30-day readmissions were determined. Multivariate logistic regression was used to identify risk factors for readmission.

Results

Among 16,902 identified cases, the 30-day, nonelective readmission rate was 10.2%, with an average cost per readmission of $14,170. The most common readmission diagnoses were postoperative bleeding (14.1%) and wound complications (12.6%) (surgical site infection [8.6%], dehiscence [2.3%], and fistula [1.7%]). On multivariate regression, significant risk factors for readmission were major ablative surgery (which included total glossectomy, pharyngectomy, and mandibulectomy) (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.06-1.60), advanced Charlson/Deyo comorbidity (OR: 2.00, 95% CI: 1.43-2.79), history of radiation (OR: 1.58, 95% CI: 1.15-2.17), Medicare (OR: 1.34, 95% CI: 1.06-1.69) or Medicaid (OR: 1.82, 95% CI: 1.32-2.50) payer status, index admission from the emergency department (OR: 1.19, 95% CI: 1.02-1.40), and length of stay ≥6 days (OR: 1.57, 95% CI: 1.19-2.08).

Conclusions

In this large database analysis, we found that approximately one in 10 patients undergoing surgery for oropharyngeal cancer is readmitted within 30 days. Procedural complexity, insurance status, and advanced comorbidity are independent risk factors, whereas postoperative bleeding and wound complications are the most common reasons for readmission.

Level of Evidence

4. Laryngoscope, 129:910–918, 2019

Supporting Information

BIBLIOGRAPHY

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Citing Literature

Volume129, Issue4

April 2019

Pages 910-918

Readmission after surgery for oropharyngeal cancer: An analysis of rates, causes, and risk factors

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Information

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Readmission after surgery for oropharyngeal cancer: An analysis of rates, causes, and risk factors

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Related

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