A national analysis of readmissions for wound healing complications following the repair of lower back, hip, and buttock pressure ulcers using the Nationwide Readmissions Database

Abstract

Background: Traditionally, a 30-day postoperative period is used to assess outcomes in surgery. However, it is not clear if this is sufficient. Our study assessed readmissions and their risk factors following the surgical repair of pressure ulcers in a 90-day postoperative period.

Methods: Patients with a pressure ulcer to the lower back, hip, and/or buttocks who underwent a pedicled or flap based wound operation were identified in the National Readmissions Database. We then analyzed risk factors for overall 0-90-day readmissions, early readmissions (0-30 days), and late-readmissions (31-90 days).

Results: 3329 patients were identified, of which 154 (4.66%) had surgical wound-related readmissions. A majority of these occurred after 30 days (53.89%). 90% of patients with a surgical-wound related readmission were readmitted within 63 days of index procedure.

Conclusions: The traditional 30-day outcome period is not enough to properly assess outcomes in pressure ulcer surgery such as readmission. We demonstrate that a period of at least 10 weeks and perhaps the entire global 90-day postoperative period would be more appropriate to evaluate readmissions after ulcer repair.

Keywords: National readmissions database; Pressure ulcer surgery; Pressure ulcers; Surgical outcomes; Surgical readmissions.