Patient Acuity and Operative Technique Associated with Post-Colectomy Mortality Across New York State: an Analysis of 160,792 Patients over 20 years

Ryan Lamm, Steven N. Mathews, Jie Yang, Jihye Park, Mark Talamini, Aurora D. Pryor, Dana Telem

Research output: Contribution to journalArticlepeer-review

Abstract

This study sought to characterize in-hospital post-colectomy mortality in New York State. One hundred sixty thousand seven hundred ninety-two patients who underwent colectomy from 1995 to 2014 were analyzed from the all-payer New York Statewide Planning and Research Cooperative System (SPARCS) database. Linear trends of in-hospital mortality rate over 20 years were calculated using log-linear regression models. Chi-square tests were used to compare categorical variables between patients. Multivariable regression models were further used to calculate risk of in-hospital mortality associated with specific demographics, co-morbidities, and perioperative complications. From 1995 to 2014, 7308 (4.5%) in-hospital mortalities occurred within 30 days of surgery. Over this time period, the rate of overall in-hospital post-colectomy mortality decreased by 3.3% (6.3 to 3%, p < 0.0001). The risk of in-hospital mortality for patients receiving emergent and elective surgery decreased by 1% (RR 0.99 [0.98–1.00], p = 0.0005) and 5% (RR 0.95 [0.94–0.96], p < 0.0001) each year, respectively. Patients who underwent open surgeries were more likely to experience in-hospital mortality (adjusted OR 3.65 [3.16–4.21], p < 0.0001), with an increased risk of in-hospital mortality each year (RR 1.01 [1.00–1.03], p = 0.0387). Numerous other risk factors were identified. In-hospital post-colectomy mortality decreased at a slower rate in emergent versus elective surgeries. The risk of in-hospital mortality has increased in open colectomies.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Mar 15 2017

Keywords

  • Mortality
  • New York State
  • Post-colectomy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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