Nursing home status is an independent risk factor for adverse 30-day postoperative outcomes after common, nonemergent inpatient procedures

Abstract Background Nursing home residents undergoing surgery have a higher rate of postoperative adverse outcomes than nonnursing home patients. This study seeks to determine what contribution nursing home status makes to theses occurrences, independent of comorbid conditions. Methods Using the Ame...

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Bibliographic Details
Published in:The American journal of surgery 2016-08, Vol.212 (2), p.202-208
Main Authors: Caldararo, Mario D., M.S, Stein, David E., M.D, Poggio, Juan L., M.D., M.S., F.A.C.S., F.A.S.C.R.S
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Aged
Baby boomers
Blood
Elective Surgical Procedures - adverse effects
Elective Surgical Procedures - statistics & numerical data
Female
General surgery
Homes for the Aged - statistics & numerical data
Hospitalization
Hospitals
Humans
Infections
Inpatient
Male
Medicare
Middle Aged
Mortality
Multivariate analysis
NSQIP
Nursing home
Nursing homes
Nursing Homes - statistics & numerical data
Patients
Pneumonia
Population
Postoperative Complications - epidemiology
Postoperative period
Risk Assessment
Risk Factors
Sepsis
Studies
Surgery
Surgical outcomes
Surgical Procedures, Operative - adverse effects
Surgical Procedures, Operative - statistics & numerical data
United States - epidemiology
Variables
Young Adult
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Summary:Abstract Background Nursing home residents undergoing surgery have a higher rate of postoperative adverse outcomes than nonnursing home patients. This study seeks to determine what contribution nursing home status makes to theses occurrences, independent of comorbid conditions. Methods Using the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database, the 30-day postoperative outcomes of the 5 commonest nonemergent inpatient procedures performed on nursing home residents were compared with those in nonnursing home residents using logistic regression analysis. Results Nursing home status was found to be an independent risk factor for septic complications in all procedures, for blood transfusion requirement after lower leg amputation, for pneumonia and stroke/cerebrovascular accident after thromboendarterectomy, and for mortality after partial colectomy with primary anastomosis. Conclusions These data suggest that, in addition to serving as a surrogate indicator of health status and current morbidity, residence in a nursing home makes an independent contribution to adverse postoperative outcomes.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2016.02.020