Outcomes after Robotic Ventral Hernia Repair: A Study of 21,565 Patients in the State of New York

The purpose of our study is to assess outcomes following robotic ventral hernia (RVH) repair. The New York Statewide Planning and Research Cooperative System administrative database was used to identify all patients undergoing laparoscopic ventral hernia (LVH) and RVH between 2010 and 2013. Outcome measures including complications, hospital length of stay (HLOS), 30-day readmissions, and 30-day emergency department (ED) visits were compared. Propensity score (PS) analysis was used to estimate the adjusted marginal differences between patients who underwent robotic-assisted and laparoscopic procedures. There were 20,896 LVH and 679 (3.2%) RVH repairs. Initial univariate analysis demonstrated that patients undergoing RVH had worse outcomes in terms of complications (20.18% vs 10.56%, P < 0.0001), longer HLOS (4.32 vs 2.19 days, P = 0.0023), higher rates in 30-day readmissions (9.28% vs 5.06%, P < 0.0001), and 30-day ED visits (14.43% vs 10.46%, P < 0.0001). Following PS analysis, which accounts for all patient associated variables, there was no difference found in 30-day readmission or 30-day ED visits between RVH and LVH (P = 0.2760 and 0.2043, respectively). Patients undergoing RVH had a significantly shorter HLOS (P < 0.0001) and lower rate of complications (P = 0.0134). Following PS analysis, this study demonstrates that RVH may be associated with shorter HLOS and lower complication rate. Further studies are necessary to compare laparoscopic and robotic approaches for ventral hernia.

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Similar Efficacy of Arthroscopy and Arthrotomy in Infection Eradication in the Treatment of Septic Knee: A Systematic Review and Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.801911 ◽

2022 ◽

Vol 8 ◽

Author(s):

Zhimin Liang ◽

Xiaofan Deng ◽

Lingli Li ◽

Jing Wang

Keyword(s):

Mortality Rate ◽

Length Of Stay ◽

Septic Arthritis ◽

Operative Time ◽

Similar Efficacy ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Lower Complication ◽

Lower Complication Rate ◽

Infection Eradication

Aim: To compare the arthroscopy vs. arthrotomy for the treatment of native knee septic arthritis.Methods: Electronic databases of PubMed, Embase and Cochrane Library were searched for eligible studies. Retrospective comparative studies comparing arthroscopy or arthrotomy for patients with septic arthritis of the native knee were eligible for this review. The primary outcome was recurrence of infection after first procedure. The secondary outcomes included hospital length of stay, operative time, range of motion of the involved knee after surgery, overall complications and mortality rate,Results: Thirteen trials were included in this study. There were a total of 2,162 septic arthritis knees treated with arthroscopic debridement and irrigation, and 1,889 septic arthritis knees treated with open debridement and irrigation. Arthroscopy and arthrotomy management of the knee septic arthritis showed comparable rate of reinfection (OR = 0.85; 95% CI, 0.57–1.27; P = 0.44). No significant difference was observed in hospital length of stay, operative time and mortality rate between arthroscopy and arthrotomy management group, while arthroscopy treatment was associated with significantly higher knee range of motion and lower complication rate when compared with arthrotomy treatment.Conclusion: Arthroscopy and arthrotomy showed similar efficacy in infection eradication in the treatment of native septic knee. However, arthroscopy treatment was associated with better postoperative functional recovery and lower complication rate.

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30-Day Outcomes for Total Ankle Arthroplasty in Patients With Anemia

Foot & Ankle International ◽

10.1177/10711007211017512 ◽

2021 ◽

pp. 107110072110175

Author(s):

Jordan R. Pollock ◽

Matt K. Doan ◽

M. Lane Moore ◽

Jeffrey D. Hassebrock ◽

Justin L. Makovicka ◽

...

Keyword(s):

Length Of Stay ◽

Univariate Analysis ◽

Hospital Length ◽

Total Ankle Arthroplasty ◽

Hospital Length Of Stay ◽

Preoperative Anemia ◽

Improvement Project ◽

Average Hospital ◽

Ankle Arthroplasty ◽

Reoperation Rates

Background: While anemia has been associated with poor surgical outcomes in total knee arthroplasty and total hip arthroplasty, the effects of anemia on total ankle arthroplasty remain unknown. This study examines how preoperative anemia affects postoperative outcomes in total ankle arthroplasty. Methods: A retrospective analysis was performed using the American College of Surgeons National Surgery Quality Improvement Project database from 2011 to 2018 for total ankle arthroplasty procedures. Hematocrit (HCT) levels were used to determine preoperative anemia. Results: Of the 1028 patients included in this study, 114 patients were found to be anemic. Univariate analysis demonstrated anemia was significantly associated with an increased average hospital length of stay (2.2 vs 1.8 days, P < .008), increased rate of 30-day readmission (3.5% vs 1.1%, P = .036), increased 30-day reoperation (2.6% vs 0.4%, P = .007), extended length of stay (64% vs 49.9%, P = .004), wound complication (1.75% vs 0.11%, P = .002), and surgical site infection (2.6% vs 0.6%, P = .017). Multivariate logistic regression analysis found anemia to be significantly associated with extended hospital length of stay (odds ratio [OR], 1.62; 95% CI, 1.07-2.45; P = .023) and increased reoperation rates (OR, 5.47; 95% CI, 1.15-26.00; P = .033). Anemia was not found to be a predictor of increased readmission rates (OR, 3.13; 95% CI, 0.93-10.56; P = .066) or postoperative complications (OR, 1.27; 95% CI, 0.35-4.56; P = .71). Conclusion: This study found increasing severity of anemia to be associated with extended hospital length of stay and increased reoperation rates. Providers and patients should be aware of the increased risks of total ankle arthroplasty with preoperative anemia. Level of Evidence: Level III, retrospective comparative study.

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Outcomes and National Trends for the Surgical Treatment of Lumbar Spine Trauma

BioMed Research International ◽

10.1155/2016/3623875 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Doniel Drazin ◽

Miriam Nuno ◽

Faris Shweikeh ◽

Alexander R. Vaccaro ◽

Eli Baron ◽

...

Keyword(s):

Patient Safety ◽

Lumbar Spine ◽

Univariate Analysis ◽

Multivariable Analysis ◽

Compression Fracture ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Nationwide Inpatient Sample Database ◽

Average Patient ◽

National Trends

Introduction. Operative treatment of lumbar spine compression fractures includes fusion and/or cement augmentation. Our aim was to evaluate postoperative differences in patients treated surgically with fusion, vertebroplasty, or kyphoplasty.Methods. The Nationwide Inpatient Sample Database search for adult vertebral compression fracture patients treated 2004–2011 identified 102,316 surgical patients: 30.6% underwent spinal fusion, 17.1% underwent kyphoplasty, and 49.9% underwent vertebroplasty. Univariate analysis of patient and hospital characteristics, by treatment, was performed. Multivariable analysis was used to determine factors associated with mortality, nonroutine discharge, complications, and patient safety.Results. Average patient age: fusion (46.2), kyphoplasty (78.5), vertebroplasty (76.7) (p<.0001). Gender, race, household income, hospital-specific characteristics, and insurance differences were found (p≤.001). Leading comorbidities were hypertension, osteoporosis, and diabetes. Risks for higher mortality (OR 2.0: CI: 1.6–2.5), nonroutine discharge (OR 1.6, CI: 1.6–1.7), complications (OR 1.1, CI: 1.0–1.1), and safety related events (OR 1.1, CI: 1.0–1.1) rose consistently with increasing age, particularly among fusion patients. Preexisting comorbidities and longer in-hospital length of stay were associated with increased odds of nonroutine discharge, complications, and patient safety.Conclusions. Fusion patients had higher rates of poorer outcomes compared to vertebroplasty and kyphoplasty cohorts. Mortality, nonroutine discharge, complications, and adverse events increased consistently with older age.

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Implementation of a Physician Incentivized QI Strategy to Address Time to Parenteral Analgesia in Patients with Voe in the Pediatric Emergency Department

Blood ◽

10.1182/blood-2021-148840 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 2989-2989

Author(s):

Romy Shane ◽

Sanjay J. Shah ◽

Blake Bulloch ◽

Anita Bharath

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Post Intervention ◽

Opioid Administration ◽

Ed Visits ◽

Mean Time ◽

Timely Administration ◽

Order Set

Abstract Introduction Vaso-occlusive episodes (VOE) are the most common cause of pediatric Emergency Department (ED) visits and hospitalizations in Sickle Cell Disease (SCD). The National Heart Lung and Blood Institute published an Expert Panel Report regarding the management of SCD and VOE. Their consensus statement recommends initiating analgesic therapy within 30 minutes of triage or within 60 minutes of registration in the Emergency Department. Previous studies have demonstrated that earlier maximum opioid has been associated with shorter length of hospitalization and improved time to ED disposition decision. Despite the overwhelming evidence for timely administration of parenteral analgesic, significant delays still exist in delivery of pain medication in the pediatric SCD population. Barriers to timely administration include rapid triage of SCD patients, provider ordering of pain medication, and peripheral intravenous access. Therefore, a standardized approach to pain management may improve ED management of SCD crises. In order to address timely administration of opiates to SCD patients with VOE episodes in our pediatric ED a SCD pain order set was developed. This order set implemented the use of intranasal (IN) fentanyl as a first line analgesic for SCD patients who presents to the ED with VOE. The purpose of this study was addressing barriers to decrease time to parenteral opioid administration in the pediatric ED. Methods This Quality Improvement (QI) measure was performed at a free-standing, urban pediatric ED. Patients were included if they had a diagnosis of SCD and presented with a pain score >5 and without fever. A PDSA cycle was utilized for designing and evaluating the proposed changes. This cycle consisted of three intervention phases: (1) electronic medical record (EMR) order set development in October 2019, (2) provider incentive for order set use in January 2020, and (3) nursing/patient & family education in April 2020. Baseline data was collected pre-intervention from April-September 2019. The outcomes measures were mean time to 1 st analgesic, mean time from triage to disposition, Hospital Length of Stay, and overall admission rates. Our balancing measure included 48 hour ED re-visits after discharge. Results There were 67 ED visits from April-September 2019 (pre-intervention) and 104 ED visits in the post-intervention data from October-June 2020. There was no significant difference in age or initial pain score in the pre- and post- intervention groups. Improvements were seen in: mean time to first analgesic (58 to 26 minutes), time to disposition (271 to 213 minutes). Hospital length of stay was found to increase with the introduction of IN fentanyl: pre-intervention (120 hours), phase 1 (148 hours), phase 2 (152 hours), phase 3 (218 hours). However, the overall admission rate decreased (55% to 44%). The number of 48-hour ED re-visits remained stable. Conclusion By using QI methods to address key barriers in the pediatric ED, we demonstrated that timely administration of parenteral analgesic can be achieved for SCD patients with VOE. Utilizing the EMR order set allowed for more stream-lined care, both by physicians and nursing staff, resulting in more rapid ordering of medication therefore decreasing time to ED disposition. Additional interventions such as provider incentivization to meet the goal of parenteral opioids within 30 minutes of patient arrival led to further improvement. One of the greatest barriers to our QI intervention was hesitancy both by patients and their caregivers regarding the efficacy of IN fentanyl in decreasing pain compared to IV opioid. Further education was needed both for families and medical staff regarding the efficacy of IN fentanyl as a first line analgesic. It is unclear why overall hospital length of stay was not shown to be decreased with these interventions but this can be offset by an overall decrease in hospital admissions seen with our interventions. This data may be limited by the SARS-CoV-2 pandemic and how psychosocial stressors can impact patients with chronic medical conditions. Length of stay is also confounded by other factors during the hospitalization and acquisition of other diagnoses such as acute chest. Future research is needed to determine if the demonstrated trend of admission rates and hospital length of stay can be replicated in other pediatric EDs and whether earlier opioid administration affects the outcome of VOEs beyond the ED. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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MP44: TEC4Home heart failure: using home telemonitoring to decrease ED readmissions and clinical flow

CJEM ◽

10.1017/cem.2018.198 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S56-S57

Author(s):

H. Novak Lauscher ◽

K. Ho ◽

J. L. Cordeiro ◽

A. Bhullar ◽

R. Abu Laban ◽

...

Keyword(s):

Heart Failure ◽

Length Of Stay ◽

Hospital Admissions ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Total Hospital ◽

Home Telemonitoring ◽

Patient Health ◽

Ed Visits ◽

Improve Patient

Introduction: Patients with Heart failure (HF) experience frequent decompensation necessitating multiple emergency department (ED) visits and hospitalizations. If patients are able to receive timely interventions and optimize self-management, recurrent ED visits may be reduced. In this feasibility study, we piloted the application of home telemonitoring to support the discharge of HF patients from hospital to home. We hypothesized that TEC4Home would decrease ED revisits and hospital admissions and improve patient health outcomes. Methods: Upon discharge from the ED or hospital, patients with HF received a blood pressure cuff, weight scale, pulse oximeter, and a touchscreen tablet. Participants submitted measurements and answered questions on the tablet about their HF symptoms daily for 60 days. Data were reviewed by a monitoring nurse. From November 2016 to July 2017, 69 participants were recruited from Vancouver General Hospital (VGH), St. Pauls Hospital (SPH) and Kelowna General Hospital (KGH). Participants completed pre-surveys at enrollement and post-surveys 30 days after monitoring finished. Administrative data related to ED visits and hospital admissions were reviewed. Interviews were conducted with the monitoring nurses to assess the impact of monitoring on patient health outcomes. Results: A preliminary analysis was conducted on a subsample of participants (n=22) enrolled across all 3 sites by March 31, 2017. At VGH and SPH (n=14), 25% fewer patients required an ED visit in the post-survey reporting compared to pre-survey. During the monitoring period, the monitoring nurse observed seven likely avoided ED admissions due to early intervention. In total, admissions were reduced by 20% and total hospital length of stay reduced by 69%. At KGH (n=8), 43% fewer patients required an ED visit in the post-survey reporting compared to the pre-survey. Hospital admissions were reduced by 20% and total hospital length of stay reduced by 50%. Overall, TEC4Home participants from all sites showed a significant improvement in health-related quality of life and in self-care behaviour pre- to 90 days post-monitoring. A full analysis of the 69 patients will be complete in February 2018. Conclusion: Preliminary findings indicate that home telemonitoring for HF patients can decrease ED revisits and improve patient experience. The length of stay data may also suggest the potential for early discharge of ED patients with home telemonitoring to avoid or reduce hospitalization. A stepped-wedge randomized controlled trial of TEC4Home in 22 BC communities will be conducted in 2018 to generate evidence and scale up the service in urban, regional and rural communities. This work is submitted on behalf of the TEC4Home Healthcare Innovation Community.

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PCV39: IMPACT OF ANEMIA ON HF HOSPITAL LENGTH OF STAY: LONGITUDINAL ANALYSIS OF A LARGE ADMINISTRATIVE DATABASE

Value in Health ◽

10.1016/s1098-3015(10)64153-8 ◽

2003 ◽

Vol 6 (3) ◽

pp. 321

Author(s):

RJ Nordyke ◽

M Shaw ◽

GA Goldberg ◽

RM Vendiola ◽

D Batra ◽

...

Keyword(s):

Length Of Stay ◽

Longitudinal Analysis ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Administrative Database

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Association of body mass index with morbidity in patients hospitalised with COVID-19

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2021-000970 ◽

2021 ◽

Vol 8 (1) ◽

pp. e000970

Author(s):

Maria Plataki ◽

Di Pan ◽

Parag Goyal ◽

Katherine Hoffman ◽

Jacky Man Kwan Choi ◽

...

Keyword(s):

Body Mass Index ◽

New York ◽

Body Mass ◽

Regression Models ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Linear Regression Models ◽

Discharge Disposition ◽

Home Discharge ◽

Significant Difference

PurposeTo evaluate the association between body mass index (BMI) and clinical outcomes other than death in patients hospitalised and intubated with COVID-19.MethodsThis is a single-centre cohort study of adults with COVID-19 admitted to New York Presbyterian Hospital-Weill Cornell Medicine from 3 March 2020 through 15 May 2020. Baseline and outcome variables, as well as lab and ventilatory parameters, were generated for the admitted and intubated cohorts after stratifying by BMI category. Linear regression models were used for continuous, and logistic regression models were used for categorical outcomes.ResultsThe study included 1337 admitted patients with a subset of 407 intubated patients. Among admitted patients, hospital length of stay (LOS) and home discharge was not significantly different across BMI categories independent of demographic characteristics and comorbidities. In the intubated cohort, there was no difference in in-hospital events and treatments, including renal replacement therapy, neuromuscular blockade and prone positioning. Ventilatory ratio was higher with increasing BMI on days 1, 3 and 7. There was no significant difference in ventilator free days (VFD) at 28 or 60 days, need for tracheostomy, hospital LOS, and discharge disposition based on BMI in the intubated cohort after adjustment.ConclusionsIn our COVID-19 population, there was no association between obesity and morbidity outcomes, such as hospital LOS, home discharge or VFD. Further research is needed to clarify the mechanisms underlying the reported effects of BMI on outcomes, which may be population dependent.

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Alpha-blockade during congenital heart surgery admissions: analysis from national database

Cardiology in the Young ◽

10.1017/s1047951121003875 ◽

2021 ◽

pp. 1-7

Author(s):

Brian Lee ◽

Enrique G. Villarreal ◽

Emad B. Mossad ◽

Jacqueline Rausa ◽

Ronald A. Bronicki ◽

...

Keyword(s):

Length Of Stay ◽

Congenital Heart ◽

Heart Surgery ◽

Univariate Analysis ◽

Congenital Heart Surgery ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Icu Length Of Stay ◽

Alpha Blockade ◽

Stay Hospital

Abstract Introduction: The effects of alpha-blockade on haemodynamics during and following congenital heart surgery are well documented, but data on patient outcomes, mortality, and hospital charges are limited. The purpose of this study was to characterise the use of alpha-blockade during congenital heart surgery admissions and to determine its association with common clinical outcomes. Materials and Methods: A cross-sectional study was conducted using the Pediatric Health Information System database. De-identified data for patients under 18 years of age with a cardiac diagnosis who underwent congenital heart surgery were obtained from 2004 to 2015. Patients were subdivided on the basis of receiving alpha-blockade with either phenoxybenzamine or phentolamine during admission or not. Continuous and categorical variables were analysed using Mann−Whitney U-tests and Fisher exact tests, respectively. Characteristics between subgroups were compared using univariate analysis. Regression analyses were conducted to determine the impact of alpha-blockade on ICU length of stay, hospital length of stay, billed charges, and mortality. Results: Of the 81,313 admissions, 4309 (5.3%) utilised alpha-blockade. Phentolamine was utilised in 4290 admissions. In univariate analysis, ICU length of stay, total length of stay, inpatient mortality, and billed charges were all significantly higher in the alpha-blockade admissions. However, regression analyses demonstrated that other factors were behind these increased. Alpha-blockade was significantly, independently associated with a 1.5 days reduction in ICU length of stay (p < 0.01) and a 3.5 days reduction in total length of stay (p < 0.01). Alpha-blockade was significantly, independently associated with a reduction in mortality (odds ratio 0.8, 95% confidence interval 0.7−0.9). Alpha-blockade was not independently associated with any significant change in billed charges. Conclusions: Alpha-blockade is used in a subset of paediatric cardiac surgeries and is independently associated with significant reductions in ICU length of stay, hospital length of stay, and mortality without significantly altering billed charges.

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C2 Versus C3 as the Upper Instrumented Vertebra for Cervicothoracic Posterior Laminectomy and Fusion Demonstrate Equivalent Postoperative Outcomes

Neurosurgery ◽

10.1093/neuros/nyz310_409 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Ryan K Badiee ◽

Andrew Kai-Hong Chan ◽

Joshua Rivera ◽

Chih-Chang Chang ◽

Dean Chou ◽

...

Keyword(s):

Univariate Analysis ◽

Hospital Length ◽

Postoperative Outcomes ◽

Hospital Length Of Stay ◽

Short Term ◽

Radiographic Outcomes ◽

Baseline Characteristics ◽

Upper Instrumented Vertebra ◽

Upper Thoracic ◽

Laminectomy And Fusion

Abstract INTRODUCTION For patients undergoing posterior cervical laminectomy and fusion (PCLF) with an upper thoracic lower instrumented vertebra (LIV), the evidence is unclear as to whether C2 vs C3 is the ideal upper instrumented vertebra (UIV). This study analyzes short-term postoperative outcomes for PCLF comparing cervicothoracic constructs with UIV at C2 and C3. METHODS Adult patients with degenerative cervical spine disease undergoing PCLF from 2012 to 2018 at a single center were identified. Patients with UIV at C2 or C3 and a lower instrumented vertebra (LIV) at T1 or T2 were included. Univariate analysis was performed using Student's t-test, Chi-squared test, or Fisher's exact test. Multivariate regression including variables significant at P = .20 determined the effect of UIV on clinical and radiographic outcomes. RESULTS A total of 74 patients were included, of whom 30 (40.5%) and 44 (59.5%) had a UIV at C2 and C3, respectively. Mean follow-up time was 13.8 mo. Baseline characteristics including age (C2 62.4 vs C3 63.0, P = .80) and preoperative Nurick score (C2 2.3 vs C3 2.2, P = .57) were similar across groups, though the C2 UIV group had a higher rate of revision surgery (23.3% vs 2.7%, P = .006) and diabetes (40.0% vs 9.1%, P = .003). Multivariate analysis of clinical outcomes showed no significant differences, including in the rate of postoperative complications (OR: 1.5, P = .62), discharge home (OR: 1.2, P = .35), hospital length of stay (ß = −1.17 d, P = .28) or Nurick score (ß = −0.46, P = .22). Differences in radiographic outcomes including postoperative cervical lordosis (ß = −7.4 degrees, P = .09) and cSVA (ß = −8.9 degrees, P = .08) approached but did not reach significance. CONCLUSION In a study of PCLF with upper thoracic LIV, there were no significant short-term clinical or radiographic differences between a C2 and C3 UIV when adjusting for baseline characteristics. These results may aid surgeons considering PCLF for degenerative cervical spinal disease.

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Does Fever at the Time of Discharge Have Any Impact on the Incidence of Readmission?

The American Surgeon ◽

10.1177/000313480807401204 ◽

2008 ◽

Vol 74 (12) ◽

pp. 1151-1153

Author(s):

James E. Barone

Keyword(s):

New York ◽

Patient Discharge ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Discharge Diagnosis ◽

Surgical Service ◽

The Mean ◽

Data Elements ◽

Recorded Temperature

Most physicians believe that patients who have fever within 24 hours of the planned date of discharge should be kept in the hospital until the fever resolves. A search of the literature revealed very few articles addressing this topic. The object of this study was to review a number of patient discharges from the surgical service and to document the presence or absence of fever within 24 hours of the time of discharge. The primary end point of the study was to determine the rate of readmission for both patients discharged with fever and those discharged without fever. Secondary end points were to determine whether the readmission was related to the original discharge diagnosis or the presence of fever at the time of discharge. The records of all adult patients with a hospital length of stay of ≥5 days discharged from the surgical and gynecology services from April through July of 2007 were reviewed. Deaths were excluded. The following data elements were recorded: primary discharge diagnosis; age; highest recorded temperature within 24 hours of discharge; date time and cause of readmission within 30 days; and outcome. Fever was defined as a temperature of ≥100° F. Data were entered into an Excel (Microsoft, Redmond, WA) spreadsheet, and statistical analysis was performed using χ2 and Fisher's exact tests using Primer of Biostatistics© (McGraw-Hill, New York, NY). The records of 300 consecutive patients were reviewed. Follow-up was available for 86.7 per cent of the patients, 84.4 per cent of the febrile patients, and 87.1 per cent of the nonfebrile patients. A fever of ≥100° within 24 hours of discharge was noted in 45 (15.0%) patients. The mean fever was 100.5°, with a range of 100° to 102.1°. There were 38 readmissions. Of the 45 patients with fever, seven (15.6%) were readmitted. Of those seven, four readmissions were related to the previous admitting diagnosis. Of the patients who were discharged without fever, 31 (12.2%) were readmitted with 24 of those read-missions for diagnoses related to the first admission. The rate of readmission for fever and nonfever patients was not statistically significantly different (P = 0.697). Similarly, the rate of related versus nonrelated diagnoses in both the fever and nonfever groups was not statistically significantly different (P = 0.351). The presence or absence of fever within 24 hours of patient discharge seems to have no impact on the rate of readmission within 30 days.

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