Effect of occurrence of infection-related never events on length of stay and hospital charges in patients undergoing radical neck dissection for head and neck cancer

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2013-08, Vol.116 (2), p.147-158
• Main Authors: Lee, Min Kyeong, DMD, Dodson, Thomas B., DMD, MPH, Karimbux, Nadeem Y., DMD, MMSc, Nalliah, Romesh P., BDS, Allareddy, Veerasathpurush, BDS, MBA, MHA, MMSc, PhD
• Format: Article
• Language: English
• Subjects: Bacterial Infections - economics; Bacterial Infections - epidemiology; Clostridium difficile; Comorbidity; Cross-Sectional Studies; Dentistry; Enterocolitis, Pseudomembranous - economics; Enterocolitis, Pseudomembranous - epidemiology; Female; Head and Neck Neoplasms - epidemiology; Head and Neck Neoplasms - surgery; Hospital Charges - statistics & numerical data; Hospitalization - economics; Hospitalization - statistics & numerical data; Hospitals, Teaching - economics; Hospitals, Teaching - statistics & numerical data; Humans; Length of Stay - economics; Length of Stay - statistics & numerical data; Male; Medicaid - economics; Medicaid - statistics & numerical data; Medicare - economics; Medicare - statistics & numerical data; Neck Dissection - economics; Neck Dissection - statistics & numerical data; Penicillin Resistance; Pneumonia - economics; Pneumonia - epidemiology; Postoperative Complications - economics; Postoperative Complications - epidemiology; Pressure Ulcer - economics; Pressure Ulcer - epidemiology; Retrospective Studies; Surgery; Surgical Wound Infection - economics; Surgical Wound Infection - epidemiology; United States - epidemiology
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2013.02.006

Objective To estimate the impact of infection-related never events (postoperative pneumonia, Clostridium difficile infection, infection with microorganisms resistant to penicillin, postoperative infections, and decubitus ulcers) following radical neck dissections for head and neck cancers. Study Design The 2008 Nationwide Inpatient Sample was used to select hospitalizations with HNC that underwent radical neck dissections. Predictor variables were occurrence of never events and other patient- and hospital-level factors. Outcome variables were hospitalization charges and length of stay (LOS). Regression analyses were used to measure the association between predictors and outcomes. Results Among 10,660 hospitalizations, prevalence of never events ranged from 0.2% to 5.0%. Mean hospitalization charge and LOS were $75,654 and 6.8 days, respectively. Never events were associated with 5.6-10.0 longer LOS and $49,153-$124,057 excess charges. Conclusion Occurrence of never events was associated with at least 5.6 longer hospital days and $49,153 charge compared with hospitalizations without a never event.