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More specifically, technical complications requiring additional invasive procedures [ 32 , 33 ] and cardiac-related events [ 34 ] appear to be significantly associated with late readmissions following major vascular operations. The Charlson comorbidity index can be used prospectively to identify patients who will incur high future costs. Introduction Although the notion that patient comorbidities and the level of frailty affect surgical outcomes is not novel, the complexities underlying these associations are difficult to study and quantify. Studies traditionally focus on lengths of stay and day readmissions, mainly due to the standardization of these metrics as important surrogates of health-care resource use, care delivery efficiency, and overall quality of the process. Clin Orthop Relat Res.

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Second, we did not analyze many other potentially influential variables that may have been important factors for readmission e. Variables collected included patient demographics, procedure details e.

Mortalities during the preceding time period were excluded from subsequent period analyses. Median hospital length of stay index admission was 4 days. Schematic representation of temporal changes among factors associated with readmission at, and days in this study.

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Temporal variability of readmission determinants in postoperative vascular surgery patients

Can ASA grade or Goldman's cardiac risk index predict peri-operative mortality. Factors independently associated with, and day readmissions on multivariate analyses. Are all readmissions bad readmissions? Functional outcome ba,y critical limb ischemia.

These considerations will be increasingly important in the evolving paradigm of value-based healthcare.

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More specifically, we examined predictors remid readmission at, and day time points. Table 2 Univariate analysis of factors associated with, and day readmissions. This study has several important limitations.

Univariate analyses showed that chronologic age and Goldman scores were not significantly associated with readmission at any of the predetermined lsvel.

Either a revascularization e.

While comorbidities play a prominent role in the early readmissions equation, graft-related factors, prior readmissions, and cardiovascular morbidity become increasingly important beyond the initial day postoperative period. Nevertheless, our study is strengthened by the fact that data were provided by two geographically remote institutions e. Support Center Support Center. More specifically, technical complications requiring gaky invasive procedures [ 3233 ] and cardiac-related events [ 34 ] appear to be significantly associated bsky late readmissions following major vascular operations.

Conclusion The current study examined both short-term and long-term risks for readmission in patients who underwent ERDA. A long-term survival score improves preoperative prediction of survival following major vascular surgery.

J Am Heart Assoc. Rehospitalizations among patients in the medicare fee-for-service program. With the exception of the ASA physical status, all other indices were calculated retrospectively e.

A study of 16, patients?

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Am J Manag Care. First, it is a retrospective endeavor using largely administrative data that heavily depends on the quality of information entered into the combined database. We chose to assess comorbidities using established scoring indices previously employed in predicting postoperative mortality and classifying general patient health rejix. As the value-based health-care paradigm evolves, it is likely that consequences of unplanned rehospitalization will extend well beyond the current, relatively short time horizons.

Congestive heart failure, hypertension, age 75 years, diabetes mellitus, stroke. For example, the CCI was associated with readmissions at the day marker only. Based on the need for more information regarding both short-term and long-term risk of rehospitalization in patients undergoing extremity revascularization or dialysis access ERDAwe set out to explore in greater detail the relationship between key clinical determinants demographics, clinical outcomes, and comorbidity indices and hospital readmissions across a spectrum of temporal milestones.

Introduction Although the notion that patient comorbidities and the level of frailty affect surgical outcomes is not novel, the complexities underlying these associations are difficult to study and quantify.

The relationship to preoperative testing in the medicare population.

Univariate analyses were performed for readmission as the primary endpoint at each prespecified time marker, and days.