Determinants of 30-Day Readmission after Infraumbilical Panniculectomy in a Nation-Wide Cohort

Abstract

Background: Following implementation of the Affordable Care Act, unplanned readmission has become an important metric of health care quality. We sought to identify determinants of 30-day readmission in a nationwide cohort. Methods: This is a retrospective study of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). We identified all patients undergoing infraumbilical panniculectomy from 2007 to 2017 using CPT code 15830. Patient demographics, comorbidities, and postoperative complications were analyzed. Descriptive tests and regression models were used for group comparison, significance was set at p<0.05. Results: We identified 10483 patients who underwent an infraumbilical panniculectomy. Overall, 30-day postoperative complications occurred in 14%, most commonly: surgical site infection (44%), wound dehiscence (9%), sepsis (7%), and urinary tract infection (5%) Death occurred in 14 patients. Unplanned readmission and reoperation within 30 days of discharge were found in 3% and 4% patients, respectively. Race, sex, BMI category, comorbidities, complication status, and undergoing a concurrent operation were not significant predictors of unplanned readmission (p>0.05, all). However, patients who were 50 years and older were 2.2 times more likely to have an unplanned readmission than younger patients (p=0.006). Conclusion: This is the first study of readmission rates after infraumbilical panniculectomy. Awareness of specific risk factors for readmission, particularly those that are modifiable, may serve to identify and manage high risk patients, aid in the development of pre- and postoperative clinical care guidelines, and ultimately improve patient care.