Iannuzzi et al identified risk factors associated with unplanned readmission following thyroid or parathyroid surgery (cervical endocrine surgery). These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Rochester and Brigham and Women's Hospital.
Patient selection: thyroid or parathyroid surgery
Outcome: unplanned readmission within 30 days of surgery
Parameters:
(1) diagnosis
(2) serum albumin
(3) renal function
(4) ASA class
(5) duration of hospital stay in days
|
Parameter |
Finding |
Points |
|
diagnosis |
thyroid malignancy |
1 |
|
|
other diagnosis |
0 |
|
serum albumin |
>= 3.5 g/dL |
0 |
|
|
< 3.5 g/dL (hypoalbuminemia) |
1 |
|
renal function |
normal |
0 |
|
|
insufficiency/failure |
1 |
|
ASA class |
1 to 2 |
0 |
|
|
3, 4 or 5 |
1 |
|
duration of hospital stay |
<= 1 day |
0 |
|
|
> 1 day |
1 |
score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maxium score: 5
• The higher the score the greater the risk for unplanned readmission.
|
Score |
Risk Group |
Percent Readmission |
|
0 |
low risk |
2% (OR 1) |
|
1 or 2 |
intermediate risk |
4% (OR 2.5) |
|
3 or more |
high risk |
13% (OR 9.8) |
Performance:
• The AUC (c-statistic) was 0.68.
Purpose: To determine the risk for unplanned readmission following thyroid or parathyroid surgery based on the study of Iannuzzi et al.
Objective: risk factors
ICD-10: C73, E00-E07, E20, E21,
