TY - JOUR
T1 - Unplanned 30-day readmission rates after plastic and reconstructive surgery procedures
T2 - a systematic review and meta-analysis
AU - Tapking, Christian
AU - Boson, Alexis L.
AU - Rontoyanni, Victoria G.
AU - Kowalewski, Karl F.
AU - Hundeshagen, Gabriel
AU - Haug, Valentin F.M.
AU - Houschyar, Khosrow S.
AU - Popp, Daniel
AU - Branski, Ludwik K.
N1 - Publisher Copyright:
© 2020, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/12
Y1 - 2020/12
N2 - Background: Identifying risk factors for unplanned hospital readmission is beneficial in terms of costs and utilization of resources. This systematic review aimed to identify and compare the rates and common reasons for readmission following reconstructive and esthetic surgery. Methods: Adhering to PRISMA guidelines, we searched PubMed, Web of Science, and CENTRAL database. No publication date or language restrictions were applied. Outcomes included 30-day readmission rate, reasons for readmission, and complications after reconstructive or esthetic surgery. Weighted individual study estimates were used to calculate pooled 30-day readmission rates using a random-effects approach. Risk ratios (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were used to describe pooled estimates for risk factors. Results: A total of 29 studies were included in the meta-analysis. Overall readmission rates were 10.3% (95%CI 6.3–14.3) after head and neck reconstruction, 4.6% (95%CI 3.7–5.5) after breast reconstruction, 2.4% (95%CI 1.57–3.17) after other breast surgeries, 3.0% (95%CI 0.2–5.8) after esthetic surgery, and 14.1% (95%CI 2.0–26.2) after free tissue transfer of any type. Statistically significant risk factors after head and neck reconstructions included pre-existing diabetes (RR 1.20; 95%CI 1.09–1.33), congestive heart failure (RR 1.67; 95%CI 1.43–1.94), prior radiation (OR1.17; 95%CI 1.06–1.30), and perioperative blood transfusion (OR 1.44; 95%CI:1.22–1.70). Conclusions: There is a large difference for readmission rates depending on the complexity of the procedure. Few studies report unplanned readmission rates in esthetic surgery and general free tissue transfer. Whereas readmissions after head and neck reconstruction are well-evaluated, risk factors for other reconstructive surgeries are poorly reported. Closer follow-up visits and outpatient resources could decrease readmission rates. Level of Evidence: Not ratable.
AB - Background: Identifying risk factors for unplanned hospital readmission is beneficial in terms of costs and utilization of resources. This systematic review aimed to identify and compare the rates and common reasons for readmission following reconstructive and esthetic surgery. Methods: Adhering to PRISMA guidelines, we searched PubMed, Web of Science, and CENTRAL database. No publication date or language restrictions were applied. Outcomes included 30-day readmission rate, reasons for readmission, and complications after reconstructive or esthetic surgery. Weighted individual study estimates were used to calculate pooled 30-day readmission rates using a random-effects approach. Risk ratios (RRs) or odds ratios (ORs) and 95% confidence intervals (CIs) were used to describe pooled estimates for risk factors. Results: A total of 29 studies were included in the meta-analysis. Overall readmission rates were 10.3% (95%CI 6.3–14.3) after head and neck reconstruction, 4.6% (95%CI 3.7–5.5) after breast reconstruction, 2.4% (95%CI 1.57–3.17) after other breast surgeries, 3.0% (95%CI 0.2–5.8) after esthetic surgery, and 14.1% (95%CI 2.0–26.2) after free tissue transfer of any type. Statistically significant risk factors after head and neck reconstructions included pre-existing diabetes (RR 1.20; 95%CI 1.09–1.33), congestive heart failure (RR 1.67; 95%CI 1.43–1.94), prior radiation (OR1.17; 95%CI 1.06–1.30), and perioperative blood transfusion (OR 1.44; 95%CI:1.22–1.70). Conclusions: There is a large difference for readmission rates depending on the complexity of the procedure. Few studies report unplanned readmission rates in esthetic surgery and general free tissue transfer. Whereas readmissions after head and neck reconstruction are well-evaluated, risk factors for other reconstructive surgeries are poorly reported. Closer follow-up visits and outpatient resources could decrease readmission rates. Level of Evidence: Not ratable.
KW - Breast reconstruction
KW - Esthetic surgery
KW - Free tissue transfer
KW - Head and neck reconstruction
KW - Meta-analysis
KW - Readmission
KW - Reconstructive surgery
KW - Rehospitalization
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U2 - 10.1007/s00238-020-01731-y
DO - 10.1007/s00238-020-01731-y
M3 - Review article
AN - SCOPUS:85091757359
SN - 0930-343X
VL - 43
SP - 701
EP - 712
JO - European Journal of Plastic Surgery
JF - European Journal of Plastic Surgery
IS - 6
ER -