title: Measuring the incidence of hospital-acquired complications and their effect on length of stay using CHADx.
abstract: OBJECTIVE
  To use an automated Classification of Hospital Acquired Diagnoses (CHADx) reporting system to report the incidence of hospital-acquired complications in inpatients and investigate the association between hospital-acquired complications and hospital length of stay (LOS) in multiday-stay patients.
  
  
  METHODS
  Retrospective cross-sectional study for calendar years 2010 and 2011.
  
  
  METHODS
  South Metropolitan Health Service in Western Australia, which consists of two teaching and three non-teaching hospitals.
  
  
  METHODS
  Incidence of hospital-acquired complications and mean LOS for multiday-stay patients.
  
  
  RESULTS
  Of 436 841 inpatient separations, 29 172 (6.68%) had at least one hospital-acquired complication code assigned in the administrative data, and there were a total of 56 326 complication codes. The three most common complications were postprocedural complications; cardiovascular complications; and labour, delivery and postpartum complications. In the subset of data on multiday-stay patients, crude mean LOS was longer in separations for patients with hospital-acquired complications than in separations for those without such complications (17.4 days v 5.4 days). After adjusting for potential confounders, separations for patients with hospital-acquired complications had almost four times the mean LOS of separations for those without such complications (incident rate ratio, 3.84; 95% CI, 3.73-3.96; P < 0.001).
  
  
  CONCLUSIONS
  An automated CHADx reporting system can be used to collect data on patients with hospital-acquired complications. Such data can be used to increase emphasis on patient safety and quality of care and identify potential opportunities to reduce LOS.
authors.affiliation: Performance Unit, South Metropolitan Health Service, Perth, WA, Australia. kevin.trentino@health.wa.gov.au.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Trentino
authors.forename: Stuart G
authors.initials: SG
authors.lastname: Swain
authors.forename: Sally A
authors.initials: SA
authors.lastname: Burrows
authors.forename: Peter C
authors.initials: PC
authors.lastname: Sprivulis
authors.forename: Frank F S
authors.initials: FF
authors.lastname: Daly
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003953:Diagnosis-Related Groups; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D038801:International Classification of Diseases; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors