National perspective on hospital readmissions following adrenalectomy

Background and Objective: Examining risk factors of readmission in adrenalectomy patients and estimated the cost burden of unplanned readmission on the United States??? healthcare system. Methods: According to the Nationwide Readmission Database, 20,494 patients underwent adrenalectomy between 2010???2014. Demographics, comorbidities, clinical data, length of stay (LOS), annual case volume, and discharge disposition of 30-and 90-day readmission cohorts were compared to the non-readmitted cohort. Results: A total of 1,463 (7.9%) and 1,959 (12.7%) adrenalectomy patients were readmitted at 30 and 90 days after discharge, respectively. Prolonged initial hospital stays [odds ratio (OR) =1.93; 95% confidence interval (CI): 1.63???2.27] and postoperative complications (OR =4.91; 95% CI: 1.98???12.16) were associated with a higher risk of readmission. Complications were significantly more frequent in patients with a primary or secondary malignancy (OR =1.42; 95% CI: 1.23???1.64) and in patients undergoing a procedure at a low adrenalectomy volume hospital [hazard ratio (HR) =0.75; 95% CI: 0.62???0.91; P=0.003]. Readmission extended overall LOS by an average of 2.06 days, costing an additional $18,529.49 per admission. Conclusions: Readmission adds significantly to the burden of disease after adrenalectomy. Understanding contributing factors may identify strategies to reduce readmissions and improve healthcare for patients.