Approximately 80 percent of admissions, deaths, complications, and inpatient costs related to operative emergency general surgery nationwide can be traced to only seven procedures, according to a study published online by JAMA Surgery.

These include colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, removal of peritoneal adhesions, appendectomy and laparotomy.

These collectively accounted for 80 percent of procedures, 80 percent of deaths, 79 percent of complications, and 80 percent of inpatient costs nationwide.

at highest risk, and most costly general surgery patients.

“There are more than three million patients admitted to U.S. hospitals each year for EGS diagnoses, more than the sum of all new cancer diagnoses,” the report said.

A research team from Brigham & Women's Hospital, Boston studied data from the 2008-2011 National Inpatient Sample.

Adults with primary EGS diagnoses who underwent an operative procedure within two days of admission were included in the analyses.

Among the ranked procedures, researchers assessed contributions to total EGS frequency, mortality, and hospital costs.

The study identified 421, 476 cases connected to operative EGS, weighted to represent 2.1 million nationally over the four-year study period.

The overall mortality rate was 1.2 percent and the complication rate was 15 percent. In terms of average cost per admission, this was $13, 241.

After ranking the 35 procedure groups by contribution to EGS mortality and morbidity burden, researchers identified the final set of seven operative EGS procedures.

"National quality benchmarks and cost reduction efforts should focus on these common, complicated, and costly EGS procedures," the authors write.

 

Source: JAMA Surgery

Image Credit: Pixabay

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