Risk factors for unplanned readmission in total laryngectomy patients
The Laryngoscope Jun 19, 2020
Vimawala S, Topf MC, Savard C, et al. - Researchers conducted this retrospective chart review to determine which patient or surgical factors influence the risk of unplanned readmission (within 30 days) after total laryngectomy (TL). The sample consisted of all patients who had TL at a single institution from April 2007 through August 2016. Unplanned readmission to the hospital within 30 days of discharge was the primary outcome. In order to identify risk factors for unplanned readmission, univariable and multivariable logistic regression have been carried out. Two hundred seventy‐eight patients met the requirements for inclusion. Pharyngocutaneous fistula, neck abscess, and wound breakdown were the most common reasons for readmission. Fistula, postoperative pneumonia, and history of cardiac disease were independently linked to an increased risk of 30‐day unplanned readmission on multivariate analysis. Return to OR on initial admission, however, was related to a lower risk of unplanned readmission. Unplanned readmission was linked to a delay in the initiation of adjuvant radiation. A small but significant number of TL patients undergo unplanned readmission. Patients who have unplanned readmission of 30 days may be at risk of delay in starting adjuvant therapy.
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