Assessing Vascular Surgery Readmission Data in Commonly Used Quality Metric Programs

Background: Thirty-day hospital readmissions are a critical healthcare quality metric used to evaluate hospital performance and patient outcomes. Vascular surgery readmission rates are among the highest and most costly. Accurate data on patient readmissions is essential for improving care quality and reimbursement processes. The accuracy of readmission data, often derived from quality metric programs like NSQIP and Vizient, is challenged by misclassification or improper capture of readmissions. Methods: We conducted a single-institution retrospective analysis using the NSQIP and Vizient registries to identify patients who underwent vascular surgery between 2018 and 2023 and were subsequently readmitted to our institution within 30 days. Demographic, procedural, and readmission data were reviewed to identify factors associated with procedure-related vs non-procedure related readmissions. Logistic regression was employed to determine variables that significantly predicted procedure-related readmissions. Results: Among 2375 vascular surgery operations captured by NSQIP and Vizient during the study period, 219 patients (9.2%) were readmitted within 30 days. Of these, 89 (40.6%) were procedure-related and 130 (59.4%) were non–procedure-related. Baseline demographics, comorbidities, and perioperative characteristics were largely similar between groups, although patients with non–procedure-related readmissions were more likely to be functionally dependent (39.2% vs 22.5%, P = 0.009) and current smokers (30.8% vs 20.2%, P = 0.08). In multivariable logistic regression, functional dependence (OR 0.41, 95% CI 0.19-0.88, P = 0.022) and current smoking within 1 year (OR 0.48, 95% CI 0.23-0.99, P = 0.047) were independently associated with lower odds of procedure-related readmission, suggesting that these patients are more likely to return for medical decompensation rather than surgical complications. Conclusions: Vascular surgery readmissions are frequent and costly, and factors such as functional health status and pre-existing complications should be considered in prevention strategies. Accurate documentation and coding, combined with targeted transitional care interventions, will be essential to reduce unnecessary readmissions and to ensure fair institutional benchmarking under current quality metric programs.