A telephone call 1 week after hospitalization can identify risk factors for vascular surgery readmission

J Vasc Surg. 2016 Sep;64(3):719-25. doi: 10.1016/j.jvs.2016.04.060.

Abstract

Objective: Compared with other populations, patients who undergo vascular surgery have higher 30-day hospital readmission rates of up to 25%. Postdischarge telephone call assessments have demonstrated utility in patients with significant medical comorbidities and traditionally high readmission rates. Therefore, we hypothesized that a 1-week postdischarge telephone call evaluation can identify risk factors for readmission among vascular surgery patients.

Methods: Patients who underwent a vascular surgery procedure during a 1-year period by a single vascular surgeon at one hospital received a postdischarge telephone call questionnaire to review postoperative pain, surgical site, constitutional symptoms, and follow-up arrangement. The primary outcome measure was frequency of postoperative symptoms as collected on the telephone call questionnaire. The secondary outcome measure was 30-day hospital readmission rates.

Results: Among 167 patients, 131 (78%) received a telephone call after discharge. Calls identified pain relieved by prescription medication (odds ratio, 6.67; confidence interval, 0.82-53.81; P = .05) and continued dressing application (odds ratio, 9.55; confidence interval, 0.54-166.6; P = .04) as risk factors for 30-day readmission. The 30-day readmission was not statistically different in patients who were successfully and not successfully contacted with a postdischarge telephone call (8% and 17%, respectively; P = .37).

Conclusions: Vascular surgery patients are at higher risk of 30-day readmission than are patients in other surgical subspecialties. For the majority of patients, implementing a 1-week postdischarge telephone call for short-term follow-up evaluation is feasible and can help identify potential risk factors for hospital readmission within 30 days.

MeSH terms

  • Aged
  • Analgesics / therapeutic use
  • Bandages
  • Feasibility Studies
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Missouri
  • Odds Ratio
  • Pain, Postoperative / diagnosis
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / etiology
  • Patient Readmission*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires*
  • Telephone*
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures / adverse effects*
  • Wound Healing

Substances

  • Analgesics