title: Hospitalization after Cataract Surgery in a Nationwide Managed-Care Population.
abstract: OBJECTIVE
  Little is known regarding the extent by which patients undergoing outpatient cataract surgery are at risk for postoperative hospitalization. We sought to determine the percentage of patients undergoing cataract surgery who were subsequently hospitalized, the patient characteristics associated with postoperative hospitalization, and the reasons for hospitalization.
  
  
  METHODS
  We identified all beneficiaries of a large U.S. managed care network age ≥40 years old who underwent ≥1 cataract surgery from 2001-2011. All enrollees who required inpatient hospitalization within 7, 14, 30, and 90 days following initial cataract surgery and the reasons for hospitalization were determined. Logistic regression was performed to assess factors that significantly impacted the odds of requiring postoperative hospitalization.
  
  
  RESULTS
  Among the 64,981 patients who underwent cataract surgery, rates of hospitalization within 7, 14, 30, and 90 days were 0.3%, 0.5%, 1.3% and 4.2%, respectively. Among the 10,674 patients who had no major preexisting medical comorbidities, 0.1% were hospitalized within 7 days. The odds of hospitalization increased by 35% (OR = 1.35 [CI, 1.23-1.48]) with the presence of each additional comorbidity and by 14% with each additional hospitalization in the 3 years prior to cataract surgery (OR = 1.14 [CI, 1.10-1,18]). Those who were hospitalized in the 30 days prior to cataract surgery had 524% increased odds of being hospitalized within 7 days after cataract surgery (OR = 6.24, [CI, 3.37-11.57]) compared to those with no record of preoperative hospitalization. Postoperative hospitalizations were most commonly due to cardiovascular conditions, comprising over 25% of primary diagnoses associated with hospitalization.
  
  
  CONCLUSIONS
  The risk of hospitalization after cataract surgery is low, and is very low among those with no major preexisting medical comorbidities. Opportunities may exist to limit comprehensive preoperative evaluation and testing to those who have serious pre-existing medical comorbidities.
authors.affiliation: W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: Sophia Y
authors.initials: SY
authors.lastname: Wang
authors.affiliation: W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: Taylor S
authors.initials: TS
authors.lastname: Blachley
authors.affiliation: W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Andrews
authors.affiliation: Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America.|Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, Michigan, United States of America.|School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
authors.affiliation: W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States of America.|Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee
authors.affiliation: W. K. Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States of America.|Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States of America.|Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America.
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Stein
mesh_terms: D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications