Cataract Surgery Complications and Revisit Rates Among Three States

Abstract

Purpose: To characterize population-based 30-day procedure-related readmissions (revisits) following cataract surgery.

Setting: Ambulatory cataract surgery performed in California, Florida, or New York.

Design: Retrospective cohort study.

Methods: This study used all-capture state administrative datasets. Cataract procedures from California, Florida, and New York state ambulatory surgery settings were identified using ICD-9-CM and CPT codes. Thirty-day readmissions (revisits) were identified in inpatient, ambulatory, and emergency department settings across each state.

Results: Across the 3 states, the all-cause 30-day readmission rate was 6.0% and the procedure-related readmission (revisit) rate was 1.0%. Procedure-related revisits were highest for patients aged 20-29 (2.9%) and 30-39 (2.3%) and lowest for patients aged 70-79 (0.9%). Multivariate associations between clinical characteristics and 30-day procedure-related revisits included age 20-29 (odds ratio [OR]: 3.13; 95% confidence intervals [CI]: 2.33-4.20) and age 30-39 (OR: 2.35; CI: 1.91-2.89) compared with age 70-79, male sex (OR: 1.29; CI: 1.24-1.34), races black (OR: 1.37; CI: 1.27-1.48) and Hispanic (OR: 1.16; CI: 1.08-1.24) compared with white, and Medicaid insurance (OR: 1.18, CI: 1.07-1.30) compared with Medicare. Diabetes was also associated with increased 30-day procedure-related revisits (OR: 1.093, CI: 1.024-1.168).

Conclusions: Cataract surgery is a common and, in aggregate, expensive procedure. Complication-related revisits follow a similar trend as surgical complications in large-scale population data, and may be useful as a preliminary, screening outcome measure. Our results highlight the importance of age as a risk factor for cataract surgery readmissions, and suggest a relationship between black or Hispanic race, Medicaid insurance, and diabetes associated with higher risk for cataract surgery complications.