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Race, age, insurance status, comorbidities determine hospital revisit rates for septorhinoplasty

Age, race, insurance status and number and type of comorbidities were risk factors associated with 30-day hospital revisit rates among patients who had undergone septorhinoplasty, according to study results recently published JAMA Facial Plastic Surgery.

Researchers conducted a retrospective cohort analysis that included 175,842 patients aged older than 13 years (mean age, 41 years; 58.7% male) who underwent septorhinoplasty from 2005 to 2009. They used data from state databases on inpatients, ambulatory surgery and ED utilization from California, Florida and New York to collect data on hospital revisits during the study timeframe. The data were analyzed between Sept. 1, 2014 and May 1, 2015.

Main outcome measures were hospital revisits within 30 days after an index septorhinoplasty and the primary diagnosis at the time of revisit.

The researchers found that 6.5% of patients revisited the hospital within 30 days of the septorhinoplasty procedure, and 55.5% of those visits were to the ED. Bleeding or epistaxis occurred in 1.2% of the patients and was the most common primary diagnosis.

In a multivariable analysis, patients age 41 to 65 years (adjusted OR = 1.09; 99% CI, 1.02-1.16) or older than 65 years (a OR = 1.23; 99% CI, 1.06-1.43) had an increased revisit rate. Other factors associated with increased revisit rate included black race (aOR = 1.39; 99% CI, 1.16-1.66); having Medicare (aOR = 1.55; 99% CI, 1.32-1.81) or Medicaid (aOR = 1.63; 99% CI, 1.33-2.01); diagnoses of autoimmune disorders of  immunodeficiency (aOR = 2.69; 99% CI, 1.2-6.03) coagulopathy (aOR = 2.06; 99% CI, 1.33-3.2, anxiety (aOR = 1.79; 99% CI, 1.55-2.07), or alcohol use (adjusted OR = 1.7; 99% CI, 1.35-2.14); and having had a conchal cartilage graft (aOR = 2.01; 99% CI, 1.29-3.14),” the researchers wrote.

“This information will allow physicians to identify patient populations at higher risk for return visits to the [ED], inpatient hospital setting or ambulatory surgery center to enable appropriate preoperative risk assessment and counseling regarding follow-up and potential complications,” the researchers concluded. – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.