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Risk Factors for Readmission and Adverse Outcomes in Abdominoplasty

Background: In an era of outcomes-driven medicine, being able to benchmark complication rates of various procedures is of utmost importance. The rates of readmission, reoperation, and adverse outcomes in abdominoplasty have been previously reported, although risk factors for these adverse outcomes have not been thoroughly elucidated. This study aims to identify specific independent risk factors for readmission and other adverse outcomes of abdominoplasty. Methods: This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program and identified all abdominoplasties performed in 2011 and 2012. Univariate logistic regression analysis was used to identify significant associations between preoperative risk factors and adverse outcomes. Multivariate logistic regression analysis was then used to identify independent risk factors and causes of readmission and other adverse outcomes. Results: Of the 2946 abdominoplasties identified, there were 251 readmissions (8.5 percent), 146 reoperations (5.0 percent), and 574 patients (19.5 percent) who experienced a general complication. The most common adverse outcomes were wound complications in 281 patients (9.5 percent), pulmonary complications in 67 patients (2.3 percent), and thromboembolic complications in 34 patients (1.2 percent). Multivariate regression analysis demonstrated that American Society of Anesthesiologists class above 3, preoperative cardiac comorbidities, pulmonary comorbidities, wounds or wound infections, postoperative thromboembolic complications, wound complications, and having returned to the operating room on the primary admission were independent risk factors for readmission. Conclusions: This study provides the first critical analysis of risk factors for 30-day readmission in abdominoplasty. These risk factors can aid in patient selection, surgical planning, and postoperative allocation of resources for patients undergoing abdominoplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.