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. 2022 Jun;11(6):970-980.
doi: 10.21037/gs-22-18.

National perspective on hospital readmissions following adrenalectomy

Mohammed Hussein  1 , Eman Toraih  1   2 , Ahmed Mahmoud Fouad  3 , Lauren Mueller  4 , Alexander Blum  4 , Zaid Al-Qurayshi  5 , Jeffrey Borchardt  6 , Emad Kandil  1
Affiliations

National perspective on hospital readmissions following adrenalectomy

Mohammed Hussein et al. Gland Surg. 2022 Jun.

Abstract

Background: Examining risk factors of readmission in adrenalectomy patients and estimated the cost burden of unplanned readmission on the United States' healthcare system.

Methods: According to the Nationwide Readmission Database, 20,494 patients underwent adrenalectomy between 2010-2014. Demographics, comorbidities, clinical data, length of stay (LOS), annual case volume, and discharge disposition of 30- and 90-day readmission cohorts were compared to the non-readmitted cohort.

Results: A total of 1,463 (7.9%) and 1,959 (12.7%) adrenalectomy patients were readmitted at 30 and 90 days after discharge, respectively. Prolonged initial hospital stays [odds ratio (OR) =1.93; 95% confidence interval (CI): 1.63-2.27] and postoperative complications (OR =4.91; 95% CI: 1.98-12.16) were associated with a higher risk of readmission. Complications were significantly more frequent in patients with a primary or secondary malignancy (OR =1.42; 95% CI: 1.23-1.64) and in patients undergoing a procedure at a low adrenalectomy volume hospital [hazard ratio (HR) =0.75; 95% CI: 0.62-0.91; P=0.003]. Readmission extended overall LOS by an average of 2.06 days, costing an additional $18,529.49 per admission.

Conclusions: Readmission adds significantly to the burden of disease after adrenalectomy. Understanding contributing factors may identify strategies to reduce readmissions and improve healthcare for patients.

Keywords: Adrenalectomy; complication rate; healthcare cost; length of stay (LOS); readmission rate.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-22-18/coif). EK serves as an Editor-in-Chief of Gland Surgery from May 2017 to April 2024. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow chart for selection of the study population. All numbers are presented as weighted national estimates.
Figure 2
Figure 2
Frequency and causes of readmission following adrenalectomies. Data is presented as percentage. Two-tailed Chi-square was performed between different years. Statistical significance was considered at P value <0.05. All numbers are presented as weighted national estimates. (A) Annual percentage of readmission within 30 days. (B) Causes of 30-day readmission following adrenalectomies.
Figure 3
Figure 3
Multivariable analysis of risk factors for readmission. Cox regression analysis was used. HR and 95% CI are shown. HR, hazard ratio; CI, confidence intervals.
See this image and copyright information in PMC

Comment in

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