Patients with post-discharge complications have increased rates of reoperation, 30-day death
TUESDAY, Nov. 20 (HealthDay News) -- For patients undergoing surgery, about 40 percent of complications occur post-discharge (PD) and are associated with higher rates of reoperation and death, according to research published in the November issue of the Archives of Surgery.
Hadiza S. Kazaure, M.D., from Stanford University in Palo Alto, Calif., and colleagues describe PD complications occurring within 30 days after 21 groups of inpatient general surgical procedures (551,510 adult patients).
The researchers found that 16.7 percent of patients experienced a complication. Of these, 41.5 percent occurred PD; and 75 percent of those occurred within 14 days. The highest PD complication rates were seen with proctectomy (14.5 percent), enteric fistula repair (12.6 percent), and pancreatic procedures (11.4 percent). The highest proportions of complications were seen for breast (78.7 percent), bariatric (69.4 percent), and ventral hernia (62.0 percent) repair procedures. The most common complications for all procedures were surgical site complications, infections, and thromboembolic events. The likelihood of a PD complication was increased for those with an inpatient complication (12.5 versus 6.2 percent for those without an inpatient complication). Patients with a PD complication had significantly higher rates of reoperation and death within 30 days following surgery, with the highest rates seen for those whose PD complication was preceded by an inpatient complication. PD complications correlated with the type of procedure, American Society of Anesthesiologists class higher than 3, and use of steroids.
"In summary, our analysis revealed that PD complications account for a significant burden of postoperative complications and are an important avenue for quality improvement in inpatient general surgery," the authors write.
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