Risk factors, causes, and rates associated with hospital readmission after pediatric neck mass surgery

Abstract

BackgroundTo understand rates, risk factors, and costs associated with hospital readmission in pediatric patients who underwent neck mass excision. MethodsThis was a retrospective review of the Nationwide Readmissions Database (NRD) between 2010 and 2014 of select neck mass procedures, defined as affecting the following: thyroid, salivary gland, cervical lymph nodes, branchial cleft, thymus, and head and neck vessels. We analyzed rates and causes of 30-day readmissions using univariate and multivariate logistic regression. ResultsThere were a total of 11,824 weighted cases identified with a 30-day readmission rate of 9.0% and a mean age of 9.5 years old. The sex distribution of patients undergoing neck mass procedures was 55.8% female and 44.2% male. The most common cause of readmission was associated with a comorbid condition likely unrelated to the neck mass procedure (53%). The most common procedure-related readmission causes were associated with a postoperative neck mass (14.4%), wound (13%), and infection (6.5%). In the multivariate model, number of procedures≥5 (OR: 2.11, 95% CI: 1.28–3.49), number of chronic conditions≥1 (OR: 2.33, 95% CI: 1.16–4.66), length of hospital stay of≥7 days (OR: 2.43, 95% CI: 1.48–0.3.98), and cervical lymph node procedure (OR:2.61, 95% CI: 1.47–4.63) were associated with higher readmission risk. ConclusionReadmission after surgery for pediatric neck masses is relatively common, with an average of 9.0%. Risk factors associated with readmission include length of initial hospital stay, number of chronic conditions, number of procedures performed, and undergoing a cervical lymph node procedure.