Defining Types and Determining Risk Factors for Vascular Surgery Readmissions

Abstract

Vascular surgery patients typically have numerous comorbidities, which puts them at higher risk for postoperative readmissions. This study aims to investigate the risk factors for and appropriately categorize the various types of vascular surgery readmissions. Nine hundred seventy-two patients were retrospectively reviewed. Readmissions were classified into 3 separate groups: readmissions that occurred between 0 and 30days (30-day readmissions), 31-90days (3-month readmissions), and 91-365days (1-year readmissions). Each readmission was then assigned to 1 of the 4 categories based on whether they were related to the index procedure and whether they were planned. Univariate tests were performed for demographic variables based on their type of readmission, and logistic regressions were then performed to identify predictors of each unplanned, related readmissions. The overall 30-day readmission rate was 21.9% (n=213). The unplanned, related readmission cohort (n=83) had the highest readmission rate of 8.5%. The related, planned readmission rate was 5.9% (n=58), while the unrelated, unplanned readmission rate was 5.6% (n=55). In contrast, the overall 1-year readmission rate was 40.0% (n=389), with the largest category being unplanned, unrelated readmissions at 19.7% (n=191). The unplanned, related readmission rate was 8.7% (n=85), whereas the planned, related readmission rate was 5.7% (n=55). Compared with other types of readmissions, unplanned, related readmissions tended to affect patients who were younger, had poor glycemic control, and had higher body mass indexes (BMIs). Multivariate predictors of unplanned, related readmissions were poor glycemic control at 3months (odds ratio [OR]: 2.16, P=0.03), and BMI at 30days (OR: 1.06, P=0.04) and 1year (OR: 1.05, P=0.04). Readmissions have varying risk factors depending on their category; targeting glycemic control and obesity may reduce unplanned, related readmissions.