title: Diagnoses and clinical features associated with high risk for unplanned readmission in vascular surgery. A cohort study.
abstract: BACKGROUND
  Readmission rate is an established health quality indicator. Preventable readmissions bear an unnecessary, high cost on the healthcare system. An analysis performed by the National Centre for Health Outcomes Development (NCHOD) has demonstrated an increasing trend in emergency readmissions in the UK. Vascular surgery has been reported to have high readmission rates second only to congestive heart failure. This study aims to identify diagnoses and other clinical risk factors for high unplanned readmission rates. This may be the first step to sparing both the health care system and patients of unnecessary readmissions.
  
  
  RESULTS
  The overall 30 day readmission rate for Leeds Vascular Institute was 8.8%. The two diagnoses with the highest readmission rates were lower limb ischaemia and diabetic foot sepsis. The readmission rate for medical reasons was overwhelmingly higher than for surgical reasons (6.5% and 2.3% respectively). The most common medical diagnoses were renal disease and COPD. The majority of the patients readmitted under the care of vascular surgery required further surgical treatment.
  
  
  CONCLUSIONS
  Vascular units should focus on holistic and multidisciplinary treatment of lower limb ischaemia and diabetic foot sepsis, in order to prevent readmissions. Furthermore, the early involvement and input of physicians in the treatment of vascular patients with renal disease and COPD may be appropriate.
authors.affiliation: Leeds Vascular Institute, Leeds General Infirmary, Great George St, Leeds LS1 3EX, United Kingdom.
authors.forename: Marina
authors.initials: M
authors.lastname: Yiasemidou
authors.affiliation: Leeds Vascular Institute, Leeds General Infirmary, Great George St, Leeds LS1 3EX, United Kingdom.
authors.forename: Andrew I D
authors.initials: AI
authors.lastname: Mavor
authors.affiliation: Leeds Vascular Institute, Leeds General Infirmary, Great George St, Leeds LS1 3EX, United Kingdom.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Kent
keywords: Diabetic foot sepsis; Emergency readmission; Lower limb ischaemia; Readmission rates; Vascular surgery