Patient Co-Morbidity and Functional Status Influence the Occurrence of Hospital Acquired Conditions More Strongly than Hospital Factors

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Zhobin MoghadamyeghanehLygia Stewart

Abstract

Never events (NE) and hospital-acquired conditions (HAC) are used by Medicare/Medicaid Services to define hospital performance measures that dictate payments/penalties. Pre-op patient comorbidity may significantly influence HAC development. We studied 8,118,615 patients from the NIS database (2002-2012) who underwent upper/lower gastrointestinal and/or hepatopancreatobiliary procedures. Multivariate analysis, using logistic regression, was used to identify HAC and NE risk factors. A total of 63,762 (0.8%) HAC events and 1645 (0.02%) NE were reported. A total of 99.9% of NE were retained foreign body. Most frequent HAC were: pressure ulcer stage III/IV (36.7%), poor glycemic control (26.9%), vascular catheter-associated infection (20.3%), and catheter-associated urinary tract infection (13.7%). Factors correlating with HAC included: open surgical approach (AOR: 1.25, P < 0.01), high-risk patients with significant comorbidity [severe loss function pre-op (AOR: 6.65, P < 0.01), diabetes with complications (AOR: 2.40, P < 0.01), paraplegia (AOR: 3.14, P < 0.01), metastatic cancer (AOR: 1.30, P < 0.01), age > 70 (AOR: 1.09, P < 0.01)], hospital factors [small vs. large (AOR: 1.07, P < 0.01), non-teaching vs teaching (AOR: 1.10, P < ...Continue Reading

References

Feb 26, 2000·Annals of Internal Medicine·L A Mermel
Oct 24, 2000·The American Journal of Medicine·S SaintT P Hofer
Oct 14, 2006·Journal of the American Geriatrics Society·Monidipa Dasgupta, Andrea C Dumbrell
Dec 25, 2008·Annals of Surgery·Thomas N RobinsonMarc Moss
Nov 13, 2009·American Journal of Surgery·Kamal M F Itani
Jan 2, 2010·Patient Safety in Surgery·Alan Lembitz, Ted J Clarke
Sep 21, 2010·American Journal of Surgery·Skotti ChurchJeffrey I Wallace
Apr 5, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Naomi P O'GradyUNKNOWN Healthcare Infection Control Practices Advisory Committee (HICPAC)
Jun 14, 2012·Current Opinion in Infectious Diseases·Paul A Tambyah, Jolene Oon
Oct 12, 2012·The New England Journal of Medicine·Grace M LeeAshish K Jha
Dec 22, 2012·Surgery·Winta T MehtsunMartin A Makary
Jun 18, 2014·Surgical Endoscopy·Anne O LidorMichael A Schweitzer
Apr 17, 2015·BMJ : British Medical Journal·Frank J AttenelloWilliam J Mack
Jul 29, 2015·JAMA : the Journal of the American Medical Association·Ravi RajaramKarl Y Bilimoria
Aug 26, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Zhobin MoghadamyeghanehMichael J Stamos
Oct 22, 2015·Surgical Endoscopy·Zhobin MoghadamyeghanehSteven Mills
Nov 7, 2015·Diseases of the Colon and Rectum·Zhobin MoghadamyeghanehMichael J Stamos
Nov 28, 2015·Journal of Vascular Surgery·Nishant K ShahJeffrey J Siracuse
Feb 1, 2017·Journal of the American College of Surgeons·Jason B LiuClifford Y Ko
Jul 12, 2017·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Lane KoenigSusan Xu
Oct 27, 2017·Canadian Urological Association Journal = Journal De L'Association Des Urologues Du Canada·Zhobin MoghadamyeghanehGaetano Ciancio

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Citations

Aug 21, 2020·International Journal of Gynecological Cancer : Official Journal of the International Gynecological Cancer Society·Christina FotopoulouAnna Fagotti
Oct 3, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Zhobin MoghadamyeghanehLisa Dresner

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