Hospital-acquired conditions after surgery for gynecologic cancer - An analysis of 82,304 patients.

Abstract:

OBJECTIVE:To evaluate the hospital-acquired condition (HAC) following oophorectomy and/or hysterectomy for gynecologic cancer patients based on clinical outcomes and costs. MATERIALS AND METHODS:Data were obtained from the Nationwide Inpatient Sample from 2005 to 2011. Chi-squared and Wilcoxon rank sum two-sample tests and multivariate logistic regression model were used for statistical analysis. RESULTS:Of 82,304 women (median age: 60 years, range: 1-101), 49,386 (60.0%) had endometrial, 23,510 (28.6%) had ovarian, and 9408 (11.4%) had cervical cancers. Of 135 HAC events, these involved catheter-associated urinary tract infections (n = 47), vascular catheter-associated infection (n = 41), foreign object retained after surgery (n = 19), pressure ulcers (n = 16), manifestation of poor glycemic control (n = 10), and air embolism (n = 2). Older patients (≥60 years) experienced more HACs relative to younger (0.23% vs. 0.09%; OR = 2.13, 95% CI: 1.30-3.50; p = 0.003), and patients with Medicaid experienced more HACs compared to those with private insurance (0.35% vs. 0.10%; OR = 3.09, 95% CI: 1.70-5.62; p < 0.001). Laparoscopic surgeries were associated with less HACs compared to open surgeries (0.05% vs. 0.19%; OR = 0.41, 95% CI: 0.19-0.90; p = 0.03). Length of hospitalization and hospital charges were greater for those with HACs, (12 days vs. 3 days; p < 0.001; $89,324 vs. $31,107; p < 0.001), respectively. CONCLUSION:The odds of hospital-acquired conditions were higher in older patients, open surgery, Medicaid insured with higher associated hospital charges.

journal_name

Gynecol Oncol

journal_title

Gynecologic oncology

authors

Chan JK,Gardner AB,Mann AK,Kapp DS

doi

10.1016/j.ygyno.2018.07.009

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

515-520

issue

3

eissn

0090-8258

issn

1095-6859

pii

S0090-8258(18)31065-5

journal_volume

150

pub_type

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