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Post-Surgery Complications, Mortality in Hospitals Analyzed

Though complication rates are similar, highest hospital quintile mortality is twice that of lowest

WEDNESDAY, Sept. 30 (HealthDay News) -- While post-surgery complication rates were similar across hospitals, the death rate for hospitals in the quintile with the highest complication-related mortality were nearly twice that of the lowest quintile, according to a study in the Oct. 1 issue of the New England Journal of Medicine.

Amir A. Ghaferi, M.D., of the University of Michigan in Ann Arbor, and colleagues analyzed data from the American College of Surgeons National Surgical Quality Improvement Program on 84,730 patients who had inpatient surgery between 2005 and 2007. The researchers calculated overall death rates and death rates for major complications, and ranked hospitals in the following quintiles for complication-related mortality: very low, low, medium, high, and very high.

The researchers found that overall complication rates were similar across hospital quintiles ranging from 23.5 to 27.6 percent, while major complications ranged from 14.9 percent to 18.4. Overall hospital death rates ranged from 3.5 percent for the very-low-mortality quintile to 6.9 percent for the very-high-mortality quintile, while for major complications, death rates varied from 12.5 percent in the very-low-mortality quintile to 21.4 percent in the very-high-mortality quintile.

"Although the value of avoiding complications in the first place is obvious, our findings also suggest that improving the care that patients receive once complications have occurred is crucial for reducing mortality. Such initiatives could focus on structural or organizational factors, such as promoting minimum standards for nurse staffing, intensive care unit organization or other hospital attributes associated with proficiency in treating patients whose conditions is critical or unstable," the authors write.

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