Cataract Surgery Complications and Revisit Rates Among Three States.
OBJECTIVE
To characterize population-based 30-day procedure-related readmissions (revisits) following cataract surgery.


METHODS
Ambulatory cataract surgery performed in California, Florida, or New York.


METHODS
Retrospective cohort study.


METHODS
This study used all-capture state administrative datasets. Cataract procedures from California, Florida, and New York state ambulatory surgery settings were identified using ICD-9-CM and CPT codes. Thirty-day readmissions (revisits) were identified in inpatient, ambulatory, and emergency department settings across each state.


RESULTS
Across the 3 states, the all-cause 30-day readmission rate was 6.0% and the procedure-related readmission (revisit) rate was 1.0%. Procedure-related revisits were highest for patients aged 20-29 (2.9%) and 30-39 (2.3%) and lowest for patients aged 70-79 (0.9%). Multivariate associations between clinical characteristics and 30-day procedure-related revisits included age 20-29 (odds ratio [OR]: 3.13; 95% confidence intervals [CI]: 2.33-4.20) and age 30-39 (OR: 2.35; CI: 1.91-2.89) compared with age 70-79, male sex (OR: 1.29; CI: 1.24-1.34), races black (OR: 1.37; CI: 1.27-1.48) and Hispanic (OR: 1.16; CI: 1.08-1.24) compared with white, and Medicaid insurance (OR: 1.18, CI: 1.07-1.30) compared with Medicare. Diabetes was also associated with increased 30-day procedure-related revisits (OR: 1.093, CI: 1.024-1.168).


CONCLUSIONS
Cataract surgery is a common and, in aggregate, expensive procedure. Complication-related revisits follow a similar trend as surgical complications in large-scale population data, and may be useful as a preliminary, screening outcome measure. Our results highlight the importance of age as a risk factor for cataract surgery readmissions, and suggest a relationship between black or Hispanic race, Medicaid insurance, and diabetes associated with higher risk for cataract surgery complications.
Veterans Affairs Palo Alto Health Care System, Byers Eye Institute at Stanford University, Palo Alto, California.
Suzann
S
Pershing
Department of Surgery, Stanford University, Palo Alto, California.
Douglas E
DE
Morrison
Stanford School of Medicine, Stanford, California. Electronic address: boussard@stanford.edu.
Tina
T
Hernandez-Boussard
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D002387:Cataract Extraction / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult