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Impact of postoperative remote infection on length of stay and medical costs in hospitals in Japan

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Abstract

Purpose

To analyze the impact of postoperative remote infections (PRIs) on medical expenditure.

Methods

The subjects of this retrospective study were 338 patients who had undergone gastroenterological surgery at one of the 20 Japanese institutions within the Japan Society for Surgical Infection (JSSI) and mainly authorized as educational institutions. The patients were allocated to 169 pairs of those with a PRI (PRI (+) group) matched with those without a PRI (PRI (−) group). PRIs included pneumonia, urinary tract infection (UTI), catheter-associated blood stream infection (CA-BSI), and antibiotic-associated enteritis.

Results

SSI developed in 74 of the 338 patients (22 without PRI and 52 with PRI). The SSI incidence was significantly higher in the PRI (+) group (p < 0.001). The difference in the median postoperative length of hospital stay was 15 days, indicating a significant prolongation in the PRI (+) group (p < 0.001). The PRI (+) group also had a higher rate of inter-hospital transfer (p < 0.01) and mortality (p < 0.001). Similarly, the difference in median postoperative medical fees was $6832.3, representing a significant increase in the PRI (+) group (p < 0.001).

Conclusions

The postoperative length of hospital stay is longer and the postoperative medical expenditure is higher for patients with a PRI than for those without a PRI.

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Acknowledgements

We thank Prof. Yoshitaka Murakami (Department of Medical Statistics, Toho University), whose comments and suggestions for statistics analysis were of inestimable value. We also express our sincere gratitude for the excellent cooperation provided by the collaborators and personnel in charge of information provision in the medical information departments and medical affairs divisions at the information provision medical institutions. Personnel in charge of providing information from the medical institutions (Honorific titles omitted): Eiji Tsujita, National Hospital Organization Kyushu Cancer Center; Junzo Shimizu and Ryohei Kawabata, Osaka Rosai Hospital; Yoshihiro Edamoto, National Center for Global Health and Medicine; Tsukasa Takayashiki, Chiba University; Masaru Koizumi, Jichi Medical University; Akihisa Matsuda, Nippon Medical School, Chiba Hokusoh Hospital; Makoto Nagashima, Toho University Sakura Hospital; Masamichi Mizuma, Tohoku University Hospital; Takehiro Wakasugi, Takeshi Yanagida and Nobuko Yamada, Nagoya City University; Mami Ikeda, JCHO Tokyo Takanawa Hospital; Minako Kobayashi, Mie University; Yukiko Kato, Aichi Medical University Hospital; Hitoshi Kanno, Nippon Medical School; Hiroshi Maruyama, Nippon Medical School Tama Nagayama Hospital; Kazuhiko Yoshimatsu, Saitama Prefecture Saiseikai Kurihashi Hospital; Hiroyuki Kasajima, Hakodate Municipal Hospital; Futoshi Teranishi, Toyokawa City Hospital; Masahiko Sakoda, Kagoshima University School of Medicine; Michinori Matsumoto, The Jikei University School of Medicine.

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Authors and Affiliations

  1. Department of Surgery, Toho University Medical Center Ohashi Hospital, Tokyo, Japan

    Hironobu Nishimuta, Manabu Watanabe, Koji Asai, Takaharu Kiribayashi & Toru Niitsuma

  2. Department of Surgery, Tohokamagaya Hospital, 594 Awano, Kamagaya, Chiba, Japan

    Shinya Kusachi

  3. Department of Surgery, Japan Medical University Tamanagayama Hospital, 1-7-1 Nagayama, Tama, Tokyo, Japan

    Hiroshi Maruyama

  4. Department of Cardiovascular Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, Japan

    Kazuo Tanemoto

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  1. Hironobu Nishimuta
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  2. Shinya Kusachi
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  3. Manabu Watanabe
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  4. Koji Asai
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  5. Takaharu Kiribayashi
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  6. Toru Niitsuma
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  7. Hiroshi Maruyama
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Correspondence to Shinya Kusachi.

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Hironobu Nishimuta and the co-authors have no conflicts of interest.

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Nishimuta, H., Kusachi, S., Watanabe, M. et al. Impact of postoperative remote infection on length of stay and medical costs in hospitals in Japan. Surg Today 51, 212–218 (2021). https://doi.org/10.1007/s00595-020-02113-4

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  • DOI: https://doi.org/10.1007/s00595-020-02113-4

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