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Failure to rescue after major abdominal surgery: The role of hospital safety net burden.
- Source :
-
American journal of surgery [Am J Surg] 2020 Oct; Vol. 220 (4), pp. 1023-1030. Date of Electronic Publication: 2020 Mar 12. - Publication Year :
- 2020
-
Abstract
- Background: We aimed to examine whether safety-net burden is a significant predictor of failure-to-rescue (FTR) after major abdominal surgery controlling for patient and hospital characteristics, including surgical volume.<br />Methods: Data were extracted from the 2007-2011 Nationwide Inpatient Sample. FTR was defined as mortality among patients experiencing major postoperative complications. Differences in rates of complications, mortality, and FTR across quartiles of safety-net burden were assessed with univariate analyses. Multilevel regression models were constructed to estimate the association between FTR and safety-net burden.<br />Results: Among 238,645 patients, the incidence of perioperative complications, in-hospital mortality, and FTR were 33.7%, 4.4%, and 11.8%, respectively. All the outcomes significantly increased across the quartiles of safety-net burden. In the multilevel regression analyses, safety-net burden was a significant predictor of FTR after adjustment for patient and hospital characteristics, including hospital volume.<br />Conclusion: Increasing hospital safety-net burden is associated with higher odds of FTR for major abdominal surgery.<br />Competing Interests: Declarations of competing interest None.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Female
Follow-Up Studies
Hospital Mortality trends
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
United States epidemiology
Young Adult
Digestive System Surgical Procedures adverse effects
Failure to Rescue, Health Care statistics & numerical data
Hospitals, High-Volume statistics & numerical data
Postoperative Complications epidemiology
Safety-net Providers statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1883
- Volume :
- 220
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- American journal of surgery
- Publication Type :
- Academic Journal
- Accession number :
- 32199603
- Full Text :
- https://doi.org/10.1016/j.amjsurg.2020.03.014