Nursing home status is an independent risk factor for adverse 30-day postoperative outcomes after common, nonemergent inpatient procedures.
BACKGROUND
Nursing home residents undergoing surgery have a higher rate of postoperative adverse outcomes than nonnursing home patients. This study seeks to determine what contribution nursing home status makes to theses occurrences, independent of comorbid conditions.


METHODS
Using the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database, the 30-day postoperative outcomes of the 5 commonest nonemergent inpatient procedures performed on nursing home residents were compared with those in nonnursing home residents using logistic regression analysis.


RESULTS
Nursing home status was found to be an independent risk factor for septic complications in all procedures, for blood transfusion requirement after lower leg amputation, for pneumonia and stroke/cerebrovascular accident after thromboendarterectomy, and for mortality after partial colectomy with primary anastomosis.


CONCLUSIONS
These data suggest that, in addition to serving as a surrogate indicator of health status and current morbidity, residence in a nursing home makes an independent contribution to adverse postoperative outcomes.
Drexel University College of Medicine, 2900 W. Queen Lane, Philadelphia, PA 19129, USA. Electronic address: mdc342@drexel.edu.
Mario D
MD
Caldararo
Drexel University College of Medicine, 2900 W. Queen Lane, Philadelphia, PA 19129, USA; Division of Colorectal Surgery, Department of Surgery, Hahnemann University Hospital, Philadelphia, PA, USA.
David E
DE
Stein
Drexel University College of Medicine, 2900 W. Queen Lane, Philadelphia, PA 19129, USA; Division of Colorectal Surgery, Department of Surgery, Hahnemann University Hospital, Philadelphia, PA, USA.
Juan L
JL
Poggio
D000293:Adolescent; D000328:Adult; D000368:Aged; D017558:Elective Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects* / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
General surgery; Inpatient; NSQIP; Nursing home; Sepsis