Many Surgical Complications Occur After Patients Go Home
MONDAY Nov. 19, 2012 -- Problems that occur after a patient has been discharged from the hospital account for a large number of complications after general surgery, a new study finds.
Researchers analyzed national data on more than 550,000 U.S. patients (average age 55) who had inpatient general surgery between 2005 and 2012. The overall rate of postoperative complications was about 17 percent, and 41.5 percent of those complications occurred within 30 days after patients were discharged from the hospital.
Overall, about one in 14 of the patients had a post-discharge complication, according to Dr. Hadiza Kazaure, of Stanford University, and colleagues.
Patients who had a complication while in the hospital were more likely to have a complication after discharge than those without an inpatient complication (12.5 percent versus about 6 percent), according to the study in the November issue of the journal Archives of Surgery.
Compared to those without a post-discharge complication, patients with this kind of complication had higher rates of reoperation (nearly 5 percent versus 18 percent) and death (2 percent versus nearly 7 percent) within 30 days after surgery.
Patients whose post-discharge complication came after also having an inpatient complication had the highest rates of reoperation (nearly 34 percent) and death (nearly 25 percent).
"In summary, our analysis revealed that [post-discharge] complications account for a significant burden of postoperative complications and are an important avenue for quality improvement in inpatient general surgery," the study authors concluded.
In an accompanying journal commentary, Dr. Desmond Winter, of St. Vincent's University Hospital in Dublin, wrote, "Patient needs, not financial penalties, should be everyone's primary focus. Let us see further advancements in surgical care through research funded by the proposed insurer savings and together strive for safer surgery."
Posted: November 2012