Revisits and readmissions following ambulatory uvulopalatopharyngoplasty.
OBJECTIVE
Determine rates and reasons for revisits after adult uvulopalatopharyngoplasty (UPPP).


METHODS
Cross-sectional analysis of multistate ambulatory surgery and hospital databases.


METHODS
Ambulatory adult UPPP cases were extracted from the State Ambulatory Surgery Databases for New York, Florida, Iowa, and California for 2010. Cases were linked to the State Emergency Department Databases and the State Inpatient Databases for visit encounters occurring 0 to 14 days after the procedure. The number of revisits (including readmissions) was determined as well as the diagnosis at the revisit. The overall mortality rate and intervention rate for postprocedural bleeding were determined.


RESULTS
A total of 2,349 ambulatory UPPP cases were extracted (mean age, 44.9 years). Overall, 9.7% of patients had a revisit after surgery (13.7% revisited the ambulatory surgery center, 68.3% the emergency department. and 18.1% to inpatient admission). The primary diagnoses at the first revisit were bleeding (38.3%), acute pain (21.2%), and fever/dehydration (6.6%). Overall, 1.6% of patients incurred a second revisit. Among all cases, 3.7% and 0.6% presented with a bleeding diagnosis at a first and second revisit, respectively. Among revisits, 11.5% and 26.3% underwent a procedure to control bleeding at the first and second revisits, respectively. One death occurred for an overall 14-day mortality rate of 0.043%.


CONCLUSIONS
Ambulatory UPPP demonstrates an good postoperative safety profile. Postoperative hemorrhage and acute pain, as well as fever/dehydration, are common reasons for revisits. These particular complications should be targeted for prevention to reduce postoperative revisit rates.
Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
Neil
N
Bhattacharyya
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology
Uvulopalatopharyngoplasty; dehydration; postoperative hemorrhage; readmission; safety; sleep apnea; surgical complications