title: Risk factors for unplanned hospital readmission in otolaryngology patients.
abstract: OBJECTIVE
  Identify the risk factors that predict 30-day unplanned readmission in hospitalized otolaryngology patients.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Single academic hospital.
  
  
  METHODS
  All otolaryngology admissions for the 1-year period between January 1, 2011, and December 31, 2011, at an academic hospital were reviewed. Univariate logistic regression and multivariate logistic regression, employing a backward elimination stepwise approach, were performed to identify risk factors for unplanned readmission to the hospital within 30 days of discharge from the otolaryngology service.
  
  
  RESULTS
  There were 1058 patients that accounted for 1271 hospital admissions. The 30-day unplanned readmission rate for patients discharged from the otolaryngology service was 7.3% (93/1271). Significant predictors identified on univariate analysis were used to build a multivariable logistic regression model of risk factors for unplanned readmission. These risk factors included presence of a complication (odds ratio [OR] = 11.60, 95% confidence interval [CI], 7.11-18.93), new total laryngectomy (OR = 4.72, 95% CI, 1.58-14.10), discharge destination of skilled nursing facility (OR = 2.70, 95% CI, 1.21-6.02), severe coronary artery disease or chronic lung disease (OR = 2.33, 95% CI, 1.38-3.93), and current illicit drug use (OR = 2.60, 95% CI, 1.27-5.34). The discriminative ability of the multivariate regression model to predict unplanned readmissions, as measured by the c-statistic, was 0.85.
  
  
  CONCLUSIONS
  Otolaryngology patients have unique risk factors that predict unplanned readmission within 30 days of discharge. These data identify specific patient characteristics and care processes that can be targeted with quality improvement interventions to decrease unplanned readmissions.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Evan M
authors.initials: EM
authors.lastname: Graboyes
authors.forename: Tzyy-Nong
authors.initials: TN
authors.lastname: Liou
authors.forename: Dorina
authors.initials: D
authors.lastname: Kallogjeri
authors.forename: Brian
authors.initials: B
authors.lastname: Nussenbaum
authors.forename: Jason A
authors.initials: JA
authors.lastname: Diaz
mesh_terms: D000368:Aged; D014487:Centers for Medicare and Medicaid Services, U.S.; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007825:Laryngectomy; D016015:Logistic Models; D008171:Lung Diseases / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010038:Otorhinolaryngologic Diseases / Q000453:epidemiology / Q000628:therapy*; D010359:Patient Readmission / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities; D014140:Tracheotomy; D014481:United States
keywords: complication; otolaryngology; readmission; unplanned