Skip to main content

Association of postdischarge complications with reoperation and mortality in general surgery.

Publication ,  Journal Article
Kazaure, HS; Roman, SA; Sosa, JA
Published in: Arch Surg
November 2012

OBJECTIVES: To describe procedure-specific types, rates, and risk factors for postdischarge (PD) complications occurring within 30 days after 21 groups of inpatient general surgery procedures. DESIGN: Retrospective cohort study. SETTING: American College of Surgeons National Surgical Quality Improvement Program 2005 through 2010 Participant Use Data Files. PATIENTS: A total of 551,510 adult patients who underwent one of 21 groups of general surgery procedures in the inpatient setting. MAIN OUTCOME MEASURES: Postdischarge complications, reoperation, and mortality. RESULTS: Of 551,510 patients (mean age, 54.6 years), 16.7% experienced a complication; 41.5% occurred PD. Of the PD complications, 75.0% occurred within 14 days PD. Proctectomy (14.5%), enteric fistula repair (12.6%), and pancreatic procedures (11.4%) had the highest PD complication rates. Breast, bariatric, and ventral hernia repair procedures had the highest proportions of complications that occurred PD (78.7%, 69.4%, and 62.0%, respectively). For all procedures, surgical site complications, infections, and thromboembolic events were the most common. Occurrence of an inpatient complication increased the likelihood of a PD complication (12.5% vs 6.2% without an inpatient complication; P < .001). Compared with patients without a PD complication, those with a PD complication had higher rates of reoperation (4.6% vs 17.9%, respectively; P < .001) and death (2.0% vs 6.9%, respectively; P < .001) within 30 days after surgery; those whose PD complication was preceded by an inpatient complication had the highest rates of reoperation (33.7%) and death (24.7%) (all P < .001). After adjustment, PD complications were associated with procedure type, American Society of Anesthesiologists class higher than 3, and steroid use. CONCLUSIONS: The PD complication rates vary by procedure, are commonly surgical site related, and are associated with mortality. Fastidious, procedure-specific patient triage at discharge as well as expedited patient follow-up could improve PD outcomes.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Arch Surg

DOI

EISSN

1538-3644

Publication Date

November 2012

Volume

147

Issue

11

Start / End Page

1000 / 1007

Location

United States

Related Subject Headings

  • United States
  • Survival Analysis
  • Surgical Procedures, Operative
  • Surgery
  • Sex Distribution
  • Risk Assessment
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Patient Readmission
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kazaure, H. S., Roman, S. A., & Sosa, J. A. (2012). Association of postdischarge complications with reoperation and mortality in general surgery. Arch Surg, 147(11), 1000–1007. https://doi.org/10.1001/2013.jamasurg.114
Kazaure, Hadiza S., Sanziana A. Roman, and Julie A. Sosa. “Association of postdischarge complications with reoperation and mortality in general surgery.Arch Surg 147, no. 11 (November 2012): 1000–1007. https://doi.org/10.1001/2013.jamasurg.114.
Kazaure HS, Roman SA, Sosa JA. Association of postdischarge complications with reoperation and mortality in general surgery. Arch Surg. 2012 Nov;147(11):1000–7.
Kazaure, Hadiza S., et al. “Association of postdischarge complications with reoperation and mortality in general surgery.Arch Surg, vol. 147, no. 11, Nov. 2012, pp. 1000–07. Pubmed, doi:10.1001/2013.jamasurg.114.
Kazaure HS, Roman SA, Sosa JA. Association of postdischarge complications with reoperation and mortality in general surgery. Arch Surg. 2012 Nov;147(11):1000–1007.

Published In

Arch Surg

DOI

EISSN

1538-3644

Publication Date

November 2012

Volume

147

Issue

11

Start / End Page

1000 / 1007

Location

United States

Related Subject Headings

  • United States
  • Survival Analysis
  • Surgical Procedures, Operative
  • Surgery
  • Sex Distribution
  • Risk Assessment
  • Retrospective Studies
  • Reoperation
  • Postoperative Complications
  • Patient Readmission