A long-term survival score improves preoperative prediction of survival following major vascular surgery. Study variables Variables collected included patient demographics, procedure details e. In-hospital worsening heart failure and associations with mortality, readmission, and healthcare utilization. Results Study cohort A total of of patients with complete medical records met inclusion criteria and were entered into this analysis. For the purposes of the current study, postoperative readmission was defined as any inpatient admission at , , and days from the time of discharge following the initial ERDA procedure encounter. Discussion The modern health-care delivery paradigm, centered on optimizing quality and value, puts increasing emphasis on the reduction of postoperative hospital stays, readmission rates, complications, and mortality. Rates and predictors of readmission after minor lower extremity amputations. 
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Cerebrovascular accident as composite clinical endpoint. A better understanding of how risk factors for readmission evolve during the postoperative period may allow vascular surgeons to more effectively tailor their practice to outcome optimization.
Recorded complications during each respective postoperative period were categorized into predefined types i. Postoperative complications significantly elevate readmission risk.
Traditional reporting standards remi underestimate the expenditure of effort required to attain limb salvage. N Engl J Med. Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients.
Fourth, there is a component of selection bias inherent to the study, with the exclusion of nearly potentially suitable patients with incomplete medical records.
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Another important factor associated with long-term readmission is perioperative cardiac status. A total of of patients who underwent ERDA with complete medical records were included.
Predefined types of complications included the following major categories and subcategories as applicable: Validation of a combined comorbidity index. To our knowledge, similar analyses of long-term readmission patterns have not been published in the past. Key factors independently associated with, and day readmissions evolved over the study period from comorbidity and morbidity-related issues in the short-term to cardiovascular and graft patency issues in the long-term.
Later hospitalizations were characterized by more specific postoperative complications and cardiovascular morbidity, suggesting that not all comorbidities consistently contribute to readmission risk. Risk score for unplanned vascular readmissions. Clinical data were abstracted from hospital records, outpatient clinic electronic records, and follow-up charts as documented by attending physicians, fellows, and residents at both institutions.
Cardiac risk stratification for high-risk vascular surgery. American Society of Anesthesiologists. J Am Coll Surg.
Details regarding patient demographic data, comorbidity and physiologic indices, complications, as well as procedure characteristics, can be found in Table 1.
Discussion The modern health-care delivery paradigm, centered on optimizing quality and value, puts increasing emphasis on the reduction of postoperative hospital stays, readmission rates, complications, and mortality. Finally, there is probably some patient selection bias originating from the fact that both participating institutions are large teaching hospitals and regional referral centers, with inherently elevated surgical case complexity and acuity.
Categorical variables were analyzed using the Fisher's exact test. Studies traditionally focus on lengths of stay and day readmissions, mainly due to the standardization of these metrics as important surrogates of health-care resource use, care delivery efficiency, and overall quality of the process.
Frailty as a predictor of surgical outcomes in older patients. Specific influence of cardiac factors and implications for preoperative evaluation.
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Ldvel all readmissions bad readmissions? Perioperative-and long-term mortality rates after major vascular surgery: These findings imply a need for early prevention, starting with the technical aspects of the procedure, as well as the importance of perioperative care to prevent complications, with the goal of reducing excess readmission rates.
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Table 2 Univariate analysis of factors associated with, and day readmissions. Readmissions were analyzed at, and days against the variables listed above to identify statistically significant univariate associations with primary study outcomes.
A new look at outcomes after infrainguinal bypass surgery: Luke's University Health Network between and Frailty and early hospital readmission after kidney transplantation.
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