Skip to main content

Advertisement

Log in

Variations in complication rates and opportunities for improvement in quality of care for patients having abdominal aortic surgery

  • Original Article
  • Published:
Langenbeck’s Archives of Surgery Aims and scope Submit manuscript

Abstract.

Background. The purpose was to assess the current variation in complication rates and evaluate the association between specific types of complications and in-hospital mortality and total hospital charges for patients having abdominal aortic surgery. Patients/methods. We studied 2987 patients for abdominal aortic surgery in Maryland from 1994 to 1996 and used discharge diagnoses and procedure codes to identify diagnoses that most likely represent major surgery complications. We evaluated how in-hospital mortality and total hospital charges related to specific complications, adjusting for patient demographics, severity of illness, comorbidity, and hospital and surgeon volumes. Discharge data was obtained from the hospital marketing departments. Results. Complication rates varied widely among hospitals. Complications independently associated with increased risk of in-hospital death include cardiac arrest with an odds ratio (OR) of 90 and a 95% confidence interval (CI) of 32–251, septicemia (OR 6.1, CI 3.3–11.3), acute myocardial infarction (OR 5.7, CI 2.3–14.3), acute renal failure (OR 5.0, CI 2.3–11.0), surgical complications after a procedure (OR 3.1, CI 2.0–4.9), and reoperation for bleeding (OR 2.2, CI 1.1–4.8). The population-attributable risk for in-hospital mortality was 47% for cardiac arrest and 27% for acute renal failure. Conclusions. In abdominal aortic surgery on patients in Maryland, the rates of some complications vary widely and are independently associated with increased in-hospital mortality and hospital charges (charges differ from costs). Efforts to reduce these complications should help to decrease both levels.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Author information

Authors and Affiliations

Authors

Additional information

Electronic Publication

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pronovost, P., Garrett, E., Dorman, T. et al. Variations in complication rates and opportunities for improvement in quality of care for patients having abdominal aortic surgery. Langenbeck’s Arch Surg 386, 249–256 (2001). https://doi.org/10.1007/s004230100216

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004230100216

Navigation