Synergistic implications of multiple postoperative outcomes.
As payment policies for surgical complications evolve, surgeons and hospitals need to understand the financial implications of postoperative events. Using data from the National Surgical Quality Improvement Program (NSQIP), the authors estimated mortality, length of stay (LOS), and total cost attributable to multiple postoperative events in general and vascular surgery patients. Data were collected using standard NSQIP practices at a single academic center between 2007 and 2009. LOS and costs were fit to linear regression models to determine the effect of 19 postoperative events in the setting of 1, 2, or 3+ events. Of 2250 patients sampled, 457 patients developed at least 1 postoperative event. LOS increased by 2.59, 5.18, and 10.99 days (P < .0001) for 1, 2, and 3+ postoperative events; excess costs were $6358, $12 802, and $42 790 (P < .0001), respectively. Multiple postoperative events have a synergistic effect on mortality, LOS, and the financial cost of patient care.
Penn State Milton S Hershey Medical Center, Hershey, PA 17033, USA.
Melissa M
MM
Boltz
Christopher S
CS
Hollenbeak
Gail
G
Ortenzi
Peter W
PW
Dillon
D000046:Academic Medical Centers; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D011183:Postoperative Complications / Q000191:economics* / Q000401:mortality; D058996:Quality Improvement / Q000706:statistics & numerical data*