TY - JOUR
T1 - Postoperative complications
T2 - an observational study of trends in the United States from 2012 to 2018
AU - Dencker, Emilie Even
AU - Bonde, Alexander
AU - Troelsen, Anders
AU - Varadarajan, Kartik Mangudi
AU - Sillesen, Martin
N1 - © 2021. The Author(s).
PY - 2021/11/6
Y1 - 2021/11/6
N2 - Background: Postoperative complications continue to constitute a major issue for both the healthcare system and the individual patient and are associated with inferior outcomes and higher healthcare costs. The objective of this study was to evaluate the trends of postoperative complication rates over a 7-year period. Methods: The NSQIP datasets from 2012 to 2018 were used to assess 30-day complication incidence rates including mortality rate following surgical procedures within ten surgical subspecialties. Multivariable logistic regression was used to associate complication rates with dataset year, while adjusting for relevant confounders. Results: A total of 5,880,829 patients undergoing major surgery were included. Particularly the incidence rates of four complications were found to be decreasing: superficial SSI (1.9 to 1.3%), deep SSI (0.6 to 0.4%), urinary tract infection (1.6 to 1.2%) and patient unplanned return to the operating room (3.1 to 2.7%). Incidence rate for organ/space SSI exhibited an increase (1.1 to 1.5%). When adjusted, regression analyses indicated decreased odds ratios (OR) through the study period years for particularly deep SSI OR 0.92 [0.92–0.93], superficial SSI OR 0.94 [0.94–0.94] and acute renal failure OR 0.96 [0.95–0.96] as the predictor variable (study year) increased (p < 0.01). However, OR’s for organ/space SSI 1.05 [1.05–1.06], myocardial infarction 1.01 [1.01–1.02] and sepsis 1.01 [1.01–1.02] increased slightly over time (all p < 0.01). Conclusions: Incidence rates for the complications exhibited a stable trend over the study period, with minor in or decreases observed.
AB - Background: Postoperative complications continue to constitute a major issue for both the healthcare system and the individual patient and are associated with inferior outcomes and higher healthcare costs. The objective of this study was to evaluate the trends of postoperative complication rates over a 7-year period. Methods: The NSQIP datasets from 2012 to 2018 were used to assess 30-day complication incidence rates including mortality rate following surgical procedures within ten surgical subspecialties. Multivariable logistic regression was used to associate complication rates with dataset year, while adjusting for relevant confounders. Results: A total of 5,880,829 patients undergoing major surgery were included. Particularly the incidence rates of four complications were found to be decreasing: superficial SSI (1.9 to 1.3%), deep SSI (0.6 to 0.4%), urinary tract infection (1.6 to 1.2%) and patient unplanned return to the operating room (3.1 to 2.7%). Incidence rate for organ/space SSI exhibited an increase (1.1 to 1.5%). When adjusted, regression analyses indicated decreased odds ratios (OR) through the study period years for particularly deep SSI OR 0.92 [0.92–0.93], superficial SSI OR 0.94 [0.94–0.94] and acute renal failure OR 0.96 [0.95–0.96] as the predictor variable (study year) increased (p < 0.01). However, OR’s for organ/space SSI 1.05 [1.05–1.06], myocardial infarction 1.01 [1.01–1.02] and sepsis 1.01 [1.01–1.02] increased slightly over time (all p < 0.01). Conclusions: Incidence rates for the complications exhibited a stable trend over the study period, with minor in or decreases observed.
KW - Humans
KW - Incidence
KW - Logistic Models
KW - Postoperative Complications/epidemiology
KW - Postoperative Period
KW - Retrospective Studies
KW - Risk Factors
KW - Surgical Wound Infection
KW - United States/epidemiology
KW - Complications
KW - Surgery
KW - Trends
UR - http://www.scopus.com/inward/record.url?scp=85118739620&partnerID=8YFLogxK
U2 - 10.1186/s12893-021-01392-z
DO - 10.1186/s12893-021-01392-z
M3 - Journal article
C2 - 34740362
VL - 21
SP - 1
EP - 10
JO - BMC Surgery
JF - BMC Surgery
SN - 1471-2482
IS - 1
M1 - 393
ER -