Obesity, anemia, and postoperative complications—especially surgical and wound complications—up risk of hospital readmission following plastic and reconstructive surgery procedures, a new study suggests.
Patients with any type of postoperative complication had the greatest increase in readmission, according to the study, which is published in Plastic and Reconstructive Surgery.
Researchers who were led by John P. Fischer, MD, of the Hospital of the University of Pennsylvania in Philadelphia, analyzed information on nearly 10,700 patients undergoing plastic and reconstructive surgical procedures during 2011, drawn from an American College of Surgeons database. The patients’ average age was 49.5 years; about 80% were women. Most patients were undergoing some type of breast surgery, including elective/ cosmetic breast surgery, breast reconstruction or revision breast procedures.
The overall rate of hospital readmission within 30 days after surgery was 4.5%, the study showed. Certain types of operations such as elective/cosmetic plastic surgery and hand surgery were associated with lower readmission rates. Patients undergoing more complex procedures—especially muscle flaps, wound debridement, or autologous reconstruction procedures—were more likely to be readmitted.
Most of the patients were healthy, although 32% were obese and 18% had anemia. After adjustment for other factors, both of these health factors were associated with an increase in readmission risk—by 20% for obese patients and 80% for those with anemia.
The overall complication rate was about 11% including nearly a five% rate of major surgical complications. After adjusted analysis, risk of readmission was six times higher for patients with surgery-related complications and five times higher for those with wound-related complications. Patients with complications related to medical conditions also had a twofold increase in readmission risk, the study showed.
“These findings highlight the importance of early recognition of complication, careful preoperative patient selection and counseling, and early intervention and close follow-up in higher-risk cohorts,” the study authors write.