30-day readmission after pediatric upper extremity surgery: Analysis of the NSQIP database.

ABSTRACT

PURPOSE: To determine the incidence and risk factors of complications, reoperations and 30-day unplanned readmission after pediatric upper extremity surgery. METHODS: Retrospective analysis of the 2013 National Surgery Quality Improvement Program pediatric database to identify procedures that met the CPT code of a primary upper extremity procedure. A univariate and multivariate analysis was performed to identify patient- and surgery-related risk factors for complications, reoperations and 30-day unplanned readmissions. RESULTS: Upper extremity pediatric surgeries have low complication (1.70%), reoperation (0.5%) and readmission rates (0.78%). Procedures requiring reoperation, inpatient procedures, and those complicated by surgical site infection were more likely to be readmitted. Patients with complex medical histories such as cardiac disease, gastrointestinal disease, pulmonary disease, or a central nervous system disorder were more likely to be readmitted. CONCLUSIONS: Pediatric upper extremity surgery is safe and associated with low complication and readmission rates. Algorithms focusing on decreasing surgical site infection and optimizing complex pediatric medical problems may limit or further decrease complication and readmission rates. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic III.