Objectives: Reducing rehospitalization rates has been proposed to improve care, reduce costs, and as a pay-for-performance criterion. Recent review of Medicare claims data indicates that vascular surgery patients have among the highest rates of 30-day rehospitalization at 23.9%.Methods: We retrospectively examined all live patient discharges (n = 799) from the vascular surgery service at a single university hospital over 12 months. Planned and unplanned 30-day rehospitalizations were distinguished, and predictors of unplanned 30-day rehospitalization were determined. To identify whether patients were readmitted to other hospitals, a prospective study of patient discharges (n = 66) over 1 month was also performed.Results: Ninety-five (11.9%) of the 799 patient discharges from the vascular surgery service were rehospitalized within 30 days. Of these, 71 were unplanned; therefore, the unplanned rehospitalization rate was 8.9%. The most common causes of unplanned 30-day rehospitalization were related to wound complications. Diabetes (P = .039) predicted unplanned 30-day rehospitalization by multivariate analysis. Patients with the diagnosis of critical limb ischemia (14.9%) and patients undergoing open lower extremity revascularization (14.6%) had the highest rates of unplanned 30-day rehospitalization. In the prospective portion of this study, no patient was readmitted to any other hospital.Conclusions: Relatively low 30-day rehospitalization was accomplished in vascular surgery patients at a single university hospital. Moreover, planned rehospitalizations accounted for approximately 25% of readmissions in vascular surgery patients. Strategies designed to reduce rehospitalization in diabetics may be warranted. (J Vase Surg 2011;54:767-72.)

Reducing rehospitalization rates has been proposed to improve care, reduce costs, and as a pay-for-performance criterion. Recent review of Medicare claims data indicates that vascular surgery patients have among the highest rates of 30-day readmission at 23.9%. We retrospectively examined all patients discharged from the vascular surgery service at a single university hospital over 12 months. We also prospectively followed patients discharged over one month. χ2 tests with Bonferroni correction were used. 96 (13%) of the 766 patients discharged from vascular surgery were readmitted within 30 days. Of the readmissions, 72 (75%) were unplanned; therefore, the unplanned readmission rate was 9%. The most frequent reasons for unplanned readmission were wound complications (29%), worsening peripheral arterial disease (PAD) or nonhealing ulcers (23%), electrolyte disturbance/emergent dialysis (8%), and graft occlusion (6%). One patient died during readmission. In the prospective study, 13% of patients were readmitted; none were readmitted to an outside hospital. The presence of diabetes predicted readmission (p < 0.001). Patients undergoing procedures for PAD (12%) and end stage renal disease (ESRD) (12%) had a higher (p = .03) readmission rate than those undergoing procedures for abdominal aortic aneurysm (4%) or carotid stenosis (4%). Rehospitalization in vascular surgery patients can be reduced below rates gleaned from interrogation of Medicare data. Diabetics and patients undergoing procedures for PAD or ESRD are more likely to be readmitted.