Hospital costs associated with surgical complications: A report from the private-sector National Surgical Quality Improvement Program

Dimick, Justin B.; Chen, Steven L.; Taheri, Paul A.; Henderson, William G.; Khuri, Shukri F.; Campbell, Darrell A.

doi:10.1016/j.jamcollsurg.2004.05.276

Cited by 833 publications

(481 citation statements)

References 16 publications

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“…3,4 However, very little research has specifically studied this association in older patients. 5,6 Compared with younger individuals, postoperative adverse events are more common in older adults after abdominal surgery, 7,8 and some patients are at exceptionally high risk for complications.…”

mentioning

confidence: 99%

The impact of adverse events on health care costs for older adults undergoing nonelective abdominal surgery

Bailey

Davis

Levy

et al. 2016

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Background: Postoperative complications have been identified as an important and potentially preventable cause of increased hospital costs. While older adults are at increased risk of experiencing complications and other adverse events, very little research has specifically examined how these events impact inpatient costs. We sought to examine the association between postoperative complications, hospital mortality and loss of independence and direct inpatient health care costs in patients 70 years or older who underwent nonelective abdominal surgery. Methods:We prospectively enrolled consecutive patients 70 years or older who underwent nonelective abdominal surgery between July 1, 2011, and Sept. 30, 2012. Detailed patient-level data were collected regarding demographics, diagnosis, treatment and outcomes. Patient-level resource tracking was used to calculate direct hospital costs (2012 $CDN). We examined the association between complications, hospital mortality and loss of independence cost using multiple linear regression.Results: During the study period 212 patients underwent surgery. Overall, 51.9% of patients experienced a nonfatal complication (32.5% minor and 19.4% major), 6.6% died in hospital and 22.6% experienced a loss of independence. On multivariate analysis nonfatal complications (p < 0.001), hospital mortality (p = 0.021) and loss of independence at discharge (p < 0.001) were independently associated with health care costs. These adverse events respectively accounted for 30%, 4% and 10% of the total costs of hospital care. Conclusion:Adverse events were common after abdominal surgery in older adults and accounted for 44% of overall costs. This represents a substantial opportunity for better patient outcomes and cost savings with quality improvement strategies tailored to the needs of this high-risk surgical population.Contexte : Les complications postopératoires sont une cause évitable qui contribue grandement aux coûts hospitaliers élevés. Malgré le fait que les personnes âgées courent un risque accru de subir des complications ou des événements indésirables, peu de recherches ont étudié l'incidence de ces éléments sur les coûts d'hospitalisation. Nous nous sommes penchés sur la relation entre les coûts des soins de santé assumés par les malades hospitalisés et les complications postopératoires, la mortalité hospitalière et la perte d'autonomie auprès d'une population de patients de 70 ans et plus ayant subi une intervention chirurgicale abdominale non facultative.Méthodes : La cohorte prospective a été formée de patients consécutifs âgés de 70 ans et plus ayant subi une intervention chirurgicale abdominale non facultative entre le 1 er juillet 2011 et le 30 septembre 2012. Des données détaillées concernant leur profil démographique, leur diagnostic, leur traitement et leurs résultats ont été recueillies. Le calcul des coûts hospitaliers directs est basé sur un suivi des ressources utilisées par les patients (en dollars canadiens, 2012). Au moyen d'une régression linéaire multiple, nous avons an...

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confidence: 99%

The impact of adverse events on health care costs for older adults undergoing nonelective abdominal surgery

Bailey

Davis

Levy

et al. 2016

cjs

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“…Varios estudios han puesto de manifiesto la importancia de la vigilancia de las IAAS, no sólo por los datos, sino también para implementar acciones de prevención 3,7 , reducir costos asociados y morbilidad 25 , y evitar los reingresos por ISQ. La literatura científica otorga un aumento promedio de 3 a 20 días de hospitalización total para los pacientes que desarrollan ISQ 25 , y las de mayor gravedad, con compromiso de músculos y fascia, tienen como consecuencia mayor frecuencia de reingresos 18 .…”

Section: Discussionunclassified

Reingreso por infección de sitio quirúrgico: una revisión integradora

Machado¹,

Turrini²,

Siqueira³

2013

Rev. chil. infectol.

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Patient readmission for surgical site infection: integrative reviewBackground: Surgical site infections (SSI) represent an inherent risk after surgical procedures associated both to the surgical procedure and to the patient clinical conditions. Aim: To analyze in an integrative review the studies related to patient readmission due to SSI. Material and Method: The review was carried out by LILACS, CINHAL, MEDLINE and COCHRANE databases and articles published from 1966 to 2010 were selected. Results: It was analyzed 13 studies classified as transversal (7), cohort (4) and longitudinal (2). Few studies analyzed only the readmissions related to the SSI. Time to define the readmission ranged from 28 to 90 days after surgery and studies related to orthopedic procedures were more frequent. The ISS readmission rates were lower than 5%. The main aetiological agents isolated from ISS were Staphylococcus aureus and coagulase-negative staphylococci. Conclusion: Monitoring readmissions due to SSI could contribute to dimension the occurrence of ISS post-discharge, once about half of the SSI post-discharge was diagnosed at the readmission moment.

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“…Post-extubation following surgery Benefit Respiratory complications play a significant role after major surgery, and can determine morbidity and mortality and substantially increase healthcare cost [42,43]. Traditionally, low-and high-flow oxygen systems have been used to reverse post-surgical respiratory complications.…”

Section: No Benefitmentioning

confidence: 99%

Nasal high flow therapy: a novel treatment rather than a more expensive oxygen device

2017

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Nasal high flow is a promising novel oxygen delivery device, whose mechanisms of action offer some beneficial effects over conventional oxygen systems. The administration of a high flow of heated and humidified gas mixture promotes higher and more stable inspiratory oxygen fraction values, decreases anatomical dead space and generates a positive airway pressure that can reduce the work of breathing and enhance patient comfort and tolerance. Nasal high flow has been used as a prophylactic tool or as a treatment device mostly in patients with acute hypoxaemic respiratory failure, with the majority of studies showing positive results. Recently, its clinical indications have been expanded to post-extubated patients in intensive care or following surgery, for pre-and peri-oxygenation during intubation, during bronchoscopy, in immunocompromised patients and in patients with "do not intubate" status. In the present review, we differentiate studies that suggest an advantage (benefit) from other studies that do not suggest an advantage (no benefit) compared to conventional oxygen devices or noninvasive ventilation, and propose an algorithm in cases of nasal high flow application in patients with acute hypoxaemic respiratory failure of almost any cause.

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Hospital costs associated with surgical complications: A report from the private-sector National Surgical Quality Improvement Program

Cited by 833 publications

References 16 publications

The impact of adverse events on health care costs for older adults undergoing nonelective abdominal surgery

The impact of adverse events on health care costs for older adults undergoing nonelective abdominal surgery

Reingreso por infección de sitio quirúrgico: una revisión integradora

Nasal high flow therapy: a novel treatment rather than a more expensive oxygen device

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