Nationwide increase in component separation without concomitant rise in readmissions: A nationwide readmissions...

Area of Science:

• Surgery
• Abdominal Wall Reconstruction
• Surgical Complications

Background:

• Component separation technique (CST) aids primary closure in complex abdominal wall reconstruction (AWR).
• CST may be associated with increased wound complications and readmissions.
• This study analyzes 3-year trends in readmissions for AWR patients with or without CST.

Purpose of the Study:

• To examine national trends in 90-day readmissions for patients undergoing AWR.
• To compare readmission rates between patients who underwent AWR with CST versus those who did not.
• To identify risk factors associated with readmission after AWR.

Main Methods:

• Analysis of the Nationwide Readmissions Database (2016-2018) for elective AWR.
• Determination of CST prevalence, patient demographics, and 90-day complications/readmissions.
• Comparison of readmissions between CST and non-CST groups, including matched subgroups, using logistic regression.

Main Results:

• AWR patient volume was 94,784 over 3 years, with a 67.5% increase in CST use (4.0% to 6.7%).
• Overall 90-day readmission rates remained consistent (16.0%-18.2%).
• Readmissions were higher in the CST group (17.1%) vs. non-CST (15.7%) but not significant in matched subgroups. Infection was the most common reason for readmission (28.3%).

Conclusions:

• Nationwide CST use in AWR increased substantially from 2016-2018 without a corresponding rise in readmissions.
• Modifiable patient health conditions (smoking, obesity, diabetes) are significant risk factors for readmission.
• Targeting these conditions during prehabilitation may reduce readmission risk after AWR.