Association of Postoperative Complications with Hospital Costs and Length of Stay in a Tertiary Care Center

• Published in: Journal of general internal medicine : JGIM 2006-02, Vol.21 (2), p.177-180
• Main Authors: Khan, Nadia A., Quan, Hude, Bugar, Jennifer M., Lemaire, Jane B., Brant, Rollin, Ghali, William A.
• Format: Article
• Language: English
• Subjects: complications; cost; Original; perioperative; surgery
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1111/j.1525-1497.2006.00319.x

BACKGROUND: Postoperative complications are a significant source of morbidity and mortality. There are limited studies, however, assessing the impact of common postoperative complications on health care resource utilization. OBJECTIVE: To assess the association of clinically important postoperative complications with total hospital costs and length of stay (LOS) in patients undergoing noncardiac surgery. METHODS: We determined total hospital costs and LOS in all patients admitted to a single tertiary care center between July 1, 1996 and March 31, 1998 using a detailed administrative hospital discharge database. Total hospital costs and LOS were adjusted for preoperative and surgical characteristics. RESULTS: Of 7,457 patients who underwent noncardiac surgery, 6.9% developed at least 1 of the postoperative complications. These complications increased hospital costs by 78% (95% confidence interval [CI]: 68% to 90%) and LOS by 114% (95% CI: 100% to 130%) after adjustment for patient preoperative and surgical characteristics. Postoperative pneumonia was the most common complication (3%) and was associated with a 55% increase in hospital costs (95% CI: 42% to 69%) and an 89% increase in LOS (95% CI: 70% to 109%). CONCLUSIONS: Postoperative complications consume considerable health care resources. Initiatives targeting prevention of these events could significantly reduce overall costs of care and improve patient quality of care.