TY - JOUR
T1 - Patient Acuity and Operative Technique Associated with Post-Colectomy Mortality Across New York State
T2 - an Analysis of 160,792 Patients over 20 years
AU - Lamm, Ryan
AU - Mathews, Steven N.
AU - Yang, Jie
AU - Park, Jihye
AU - Talamini, Mark
AU - Pryor, Aurora D.
AU - Telem, Dana
N1 - Publisher Copyright:
© 2017, The Society for Surgery of the Alimentary Tract.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - 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.
AB - 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.
KW - Mortality
KW - New York State
KW - Post-colectomy
UR - http://www.scopus.com/inward/record.url?scp=85015239602&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85015239602&partnerID=8YFLogxK
U2 - 10.1007/s11605-017-3393-2
DO - 10.1007/s11605-017-3393-2
M3 - Article
C2 - 28299620
AN - SCOPUS:85015239602
SN - 1091-255X
VL - 21
SP - 879
EP - 884
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 5
ER -