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Published on: August 11, 2015
Readmission Following Extracranial-Intracranial Bypass Surgery: Risk Factors and Patient Characteristics Using the
Simon G Ammanuel1, Ahmed M Elbayomy1, Jacob Bethel1
1Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Insights
High body mass index (BMI) is a significant risk factor for 30-day readmission following extracranial-intracranial (EC-IC) bypass surgery. Optimizing patient BMI before surgery may reduce readmission rates.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Health Services Research
Background:
- Extracranial-intracranial (EC-IC) bypass surgery is a critical procedure for intracranial revascularization.
- Identifying risk factors for readmission is crucial for improving patient outcomes and reducing healthcare costs.
Purpose of the Study:
- To identify risk factors associated with 30-day readmission after EC-IC bypass surgery.
- To analyze data from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
Main Methods:
- Longitudinal analysis of ACS-NSQIP data from 2011-2020.
- Inclusion of patients who underwent EC-IC bypass (CPT code 61711).
- Univariate and multivariate logistic regression to identify predictors of 30-day readmission.
Main Results:
- 9.1% of 350 patients were readmitted within 30 days.
- Higher BMI, diabetes, dialysis, and Black race were associated with readmission in univariate analysis.
- Elevated BMI was identified as an independent predictor of readmission (OR 1.07, P = .015).
Conclusions:
- Body mass index (BMI) is a significant predictor of 30-day readmission post-EC-IC bypass.
- Preoperative optimization of BMI and targeted postoperative care are essential for high-risk patients.
- Further prospective studies are needed to validate findings and explore additional readmission factors.
Background And Objective:
Under select indications, extracranial-intracranial (EC-IC) bypass surgery is performed for intracranial revascularization. This study aimed to identify risk factors for 30-day readmission after EC-IC bypass surgery using data from the American College of Surgeons National Surgical Quality Improvement Program database.
Methods:
We conducted a longitudinal analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2011 to 2020. Patients who underwent EC-IC bypass, identified by current procedural terminology code 61711, were included. The primary outcome was a 30-day readmission. Variables such as age, body mass index (BMI), operation time, total length of stay, preoperative duration, sex, race, home discharge status, elective surgery status, diabetes, smoking status, dyspnea, independent status, chronic obstructive pulmonary disease, congestive heart failure, hypertension, dialysis, cancer, chronic steroid use, sepsis, septic shock, emergency surgery status, wound classification, and American Society of Anesthesiologists classification were analyzed. Statistical analysis included univariate and multivariate logistic regression to identify independent predictors of readmission.
Results:
Among 350 patients who underwent EC-IC bypass, 32 (9.1%) were readmitted within 30 days. Univariate analysis revealed that readmitted patients had a significantly higher BMI (35.0 vs 30.0, P < .001) and a higher prevalence of diabetes (53.1% vs 28.6%, P = .008), dialysis (6.3% vs 0.3%, P = .02), and Black race patients (28.1% vs 14.8%, P = .02). Multivariate analysis identified BMI as an independent predictor of readmission (OR 1.07, 95% CI 1.01-1.13, P = .015).
Conclusion:
This study highlights BMI as a significant predictor of 30-day readmission after EC-IC bypass surgery. These findings underscore the importance of preoperative optimization and targeted postoperative care for high-risk patient populations. Future research should focus on prospective studies to validate these findings and explore additional factors contributing to readmission, aiming to improve patient outcomes and reduce health care costs associated with readmissions.
