Thirty-day readmission in patients undergoing head and neck microvascular reconstruction

Background: Characteristics of 30-day unplanned readmissions after head and neck microvascular reconstruction remain poorly understood. Methods: We conducted a retrospective cohort of patients who underwent head and neck microvascular reconstruction between 2010 and 2015. Results: The 30-day unplanned readmission rate was 13.0% (64/493). The most common readmission diagnoses were dehiscence, surgical site infection, or fistula (45.3%; n529). Of the readmissions, 46.9% (30/64) occurred within 7 days of discharge from the hospital. Risk factors for readmission on multivariable analysis included body mass index (BMI)< 21 kg/m2 (odds ratio [OR] 2.47; 95% confidence interval [CI] 1.36-4.47), primary site of oropharynx (OR 1.66; 95% CI 1.17-6.06), hypopharynx/larynx (OR 3.66; 95% CI 1.70-7.88), or sinonasal/skull base (OR 4.07; 95% CI 1.43-11.55), and fistula during the index hospitalization (OR 2.98; 95% CI 1.22-7.24). Conclusion: More than 1 in 10 patients undergoing head and neck microvascular reconstruction has a 30-day unplanned readmission, most commonly related to wound complications. Further efforts are needed to determine optimal 30-day unplanned readmission reduction strategies.