TY - JOUR
T1 - Prevalence, Impact, and Risk Factors for Hospital-Acquired Conditions after Major Surgical Resection for Cancer
T2 - A NSQIP Analysis
AU - Molena, Daniela
AU - Mungo, Benedetto
AU - Stem, Miloslawa
AU - Feinberg, Richard L.
AU - Lidor, Anne O.
N1 - Publisher Copyright:
© 2014, The Society for Surgery of the Alimentary Tract.
PY - 2014/1
Y1 - 2014/1
N2 - Methods: Patients who underwent surgical resection for esophageal, gastric, hepato-biliary, pancreatic, colorectal, and lung cancer were identified using the ACS-NSQIP database (2005–2012). Early surgical outcomes were compared between HAC and non-HAC patients. Modified Poisson regression was used to identify risk factors for developing HAC.Background: The effectiveness of the CMS nonpayment policy for certain hospital-acquired conditions (HAC) is debated, since their preventability is questionable in several groups of patients. This study aimed to determine the rate of the three most common HAC in major surgical resections for cancer: surgical site infection (SSI), urinary tract infection (UTI), and venous thromboembolism (VTE). Additionally, the association of HAC with patients’ characteristics and their effect on post-operative outcomes were investigated.Results: Seventy-four thousand three hundred eighty-one patients were identified, of whom 9,479 (12.74 %) developed one or more HAC. HAC patients had significantly higher rates of 30-day mortality, return to operating room, 30-day readmission, had longer LOS, and were less likely to be discharged home. Several peri-operative patients’ factors were significantly associated with HAC.Conclusion: Our data show that the development of HAC is strongly associated to pre-operative patients’ characteristics and not only to sub-optimal peri-operative care, therefore suggesting that the nonpayment policy might be excessively penalizing.
AB - Methods: Patients who underwent surgical resection for esophageal, gastric, hepato-biliary, pancreatic, colorectal, and lung cancer were identified using the ACS-NSQIP database (2005–2012). Early surgical outcomes were compared between HAC and non-HAC patients. Modified Poisson regression was used to identify risk factors for developing HAC.Background: The effectiveness of the CMS nonpayment policy for certain hospital-acquired conditions (HAC) is debated, since their preventability is questionable in several groups of patients. This study aimed to determine the rate of the three most common HAC in major surgical resections for cancer: surgical site infection (SSI), urinary tract infection (UTI), and venous thromboembolism (VTE). Additionally, the association of HAC with patients’ characteristics and their effect on post-operative outcomes were investigated.Results: Seventy-four thousand three hundred eighty-one patients were identified, of whom 9,479 (12.74 %) developed one or more HAC. HAC patients had significantly higher rates of 30-day mortality, return to operating room, 30-day readmission, had longer LOS, and were less likely to be discharged home. Several peri-operative patients’ factors were significantly associated with HAC.Conclusion: Our data show that the development of HAC is strongly associated to pre-operative patients’ characteristics and not only to sub-optimal peri-operative care, therefore suggesting that the nonpayment policy might be excessively penalizing.
KW - Cancer
KW - Hospital-acquired condition
KW - Outcomes
KW - Surgery
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U2 - 10.1007/s11605-014-2642-x
DO - 10.1007/s11605-014-2642-x
M3 - Article
C2 - 25199948
AN - SCOPUS:84920599529
VL - 19
SP - 142
EP - 151
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
SN - 1091-255X
IS - 1
ER -