Donald E Fry1, Michael Pine2, David Locke2, Gregory Pine2. 1. Michael Pine and Associates, 1 East Upper Wacker Drive #1210, Chicago, IL 60601, USA; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, NM, USA. Electronic address: dfry@consultmpa.com. 2. Michael Pine and Associates, 1 East Upper Wacker Drive #1210, Chicago, IL 60601, USA.
Abstract
BACKGROUND: The 90-day postdischarge morbidity and mortality rates following elective and emergent bowel surgery remain poorly defined. METHODS: The 2009 to 2011 Medicare inpatient files for patients undergoing elective and emergent small and large bowel operations in 1,024 hospitals that passed present-on-admission coding accuracy standards had prediction models designed for inpatient mortality, prolonged postoperative length of hospital stay (prLOS), 90-day postdischarge mortality and readmissions, and total hospital costs. RESULTS: Of 118,758 patients studied, there was a 4.7% inpatient mortality rate and 7.3% prLOS among live discharges. An additional 7,586 deaths and 26,969 readmissions occurred within 90 days of discharge. Prolonged preoperative and prolonged postoperative hospitalizations were significant (P < .0001) variables in predicting postdischarge deaths and readmissions. Total hospital costs were increased by over $18,000 per adverse outcome. CONCLUSION: Postdischarge deaths and readmissions are more common than inpatient adverse events of death and prLOS in elective and emergent Medicare large and small bowel operations.
BACKGROUND: The 90-day postdischarge morbidity and mortality rates following elective and emergent bowel surgery remain poorly defined. METHODS: The 2009 to 2011 Medicare inpatient files for patients undergoing elective and emergent small and large bowel operations in 1,024 hospitals that passed present-on-admission coding accuracy standards had prediction models designed for inpatient mortality, prolonged postoperative length of hospital stay (prLOS), 90-day postdischarge mortality and readmissions, and total hospital costs. RESULTS: Of 118,758 patients studied, there was a 4.7% inpatient mortality rate and 7.3% prLOS among live discharges. An additional 7,586 deaths and 26,969 readmissions occurred within 90 days of discharge. Prolonged preoperative and prolonged postoperative hospitalizations were significant (P < .0001) variables in predicting postdischarge deaths and readmissions. Total hospital costs were increased by over $18,000 per adverse outcome. CONCLUSION: Postdischarge deaths and readmissions are more common than inpatient adverse events of death and prLOS in elective and emergent Medicare large and small bowel operations.
Authors: Michael D George; Joshua F Baker; Kevin Winthrop; Evo Alemao; Lang Chen; Sean Connolly; Jesse Y Hsu; Teresa A Simon; Qufei Wu; Fenglong Xie; Shuo Yang; Jeffrey R Curtis Journal: Arthritis Care Res (Hoboken) Date: 2019-07-11 Impact factor: 4.794
Authors: Michael D George; Joshua F Baker; Kevin Winthrop; Evo Alemao; Lang Chen; Sean Connolly; Jesse Y Hsu; Teresa A Simon; Qufei Wu; Fenglong Xie; Shuo Yang; Jeffrey R Curtis Journal: Ann Intern Med Date: 2019-05-21 Impact factor: 25.391
Authors: Michael D George; Joshua F Baker; Jesse Yenchih Hsu; Qufei Wu; Fenglong Xie; Lang Chen; Huifeng Yun; Jeffrey R Curtis Journal: Arthritis Care Res (Hoboken) Date: 2017-11-02 Impact factor: 4.794
Authors: Prem N Ramkumar; Chukwuweike Gwam; Sergio M Navarro; Heather S Haeberle; Jaret M Karnuta; Ronald E Delanois; Michael A Mont Journal: Ann Transl Med Date: 2019-02
Authors: Donald E Fry; Michael Pine; Susan M Nedza; David G Locke; Agnes M Reband; Gregory Pine Journal: Medicine (Baltimore) Date: 2016-09 Impact factor: 1.889
Authors: Donald E Fry; Susan M Nedza; Michael Pine; Agnes M Reband; Chun-Jung Huang; Gregory Pine Journal: Medicine (Baltimore) Date: 2018-09 Impact factor: 1.817