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A telephone call 1 week after hospitalization can identify risk factors for vascular surgery readmission
John R Hornick1, Joshua A Balderman1, Ronnie Eugea1
1Section of Vascular and Endovascular Surgery, Washington University School of Medicine, St. Louis, Mo.
Objective:
Compared with other populations, patients who undergo vascular surgery have higher 30-day hospital readmission rates of up to 25%. Postdischarge telephone call assessments have demonstrated utility in patients with significant medical comorbidities and traditionally high readmission rates. Therefore, we hypothesized that a 1-week postdischarge telephone call evaluation can identify risk factors for readmission among vascular surgery patients.
Methods:
Patients who underwent a vascular surgery procedure during a 1-year period by a single vascular surgeon at one hospital received a postdischarge telephone call questionnaire to review postoperative pain, surgical site, constitutional symptoms, and follow-up arrangement. The primary outcome measure was frequency of postoperative symptoms as collected on the telephone call questionnaire. The secondary outcome measure was 30-day hospital readmission rates.
Results:
Among 167 patients, 131 (78%) received a telephone call after discharge. Calls identified pain relieved by prescription medication (odds ratio, 6.67; confidence interval, 0.82-53.81; P = .05) and continued dressing application (odds ratio, 9.55; confidence interval, 0.54-166.6; P = .04) as risk factors for 30-day readmission. The 30-day readmission was not statistically different in patients who were successfully and not successfully contacted with a postdischarge telephone call (8% and 17%, respectively; P = .37).
Conclusions:
Vascular surgery patients are at higher risk of 30-day readmission than are patients in other surgical subspecialties. For the majority of patients, implementing a 1-week postdischarge telephone call for short-term follow-up evaluation is feasible and can help identify potential risk factors for hospital readmission within 30 days.
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