Post-Surgical Complications Often Arise After Hospital Discharge: Study

Patients who experience certain issues while undergoing in-patient medical procedures may be more likely to experience complications after discharge, increasing their chance of re-operation or death, according to new research.  

In a study published in the Archives of Surgery, researchers examined data for more than 500,000 patients who underwent general in-patient surgery procedures from 2005 through 2010, with an average age of 54 years.

The research, led by Hadiza Kazaure, MD, from the Department of General Surgery at Stanford University, found that of 21 groups of patients who underwent various surgical in-patient procedures, those who experienced in-patient complications were more likely to also experience complications after returning home.

The study found a 17% overall post-discharge complication rate following surgery and nearly 41% of the in-patients who experienced a post-discharge complication experienced it within 30 days of the initial procedure. The findings indicate that 75% of the post-operative complications occurred within just two weeks after discharge.

Post-discharge complication rates vary depending on the procedure the patient underwent; however, researchers found proctectomy, a procedure to remove the rectum due to cancer, enteric fistula repair and pancreatic procedures had the highest complication rates after discharge. Breast, bariatric and ventral hernia repair procedures also had high proportions of complications occurring post-discharge.

The retrospective cohort study used information from the American College of Surgeons national Surgical Quality Improvement Program as part of the research.

Findings of the study revealed post discharge complications led to higher incidences of re-operation, increasing the risk from 4% chance of re-operation up to an almost 18% likelihood of patients needing to undergo another operation as a result. It also determined post-discharge patients who experienced complications had a 7% risk of death if experiencing a complication within 30 days after surgery.

Patients who experienced complications while still in the hospital also experienced the most occurrences, a 34% risk, of requiring re-operation. Those patients also had an increased risk of death, a risk nearly 25% higher as a result. Many of the common complications found were surgical site complications, infections and thromboembolic events.

“Approximately 1 in 14 general surgery patients who underwent an in-patient procedure experienced a post-discharge complication,” researchers said in a press release.

Experts warn that there is constant pressure for doctors to release surgery patients much sooner, and health care professionals face new challenges to provide expedited care at the highest quality of service. Researchers urge healthcare professionals “fastidious, procedure-specific patient triage at discharge as well as expedited patient follow-up” can help improve complications following discharge from the hospital and may even possibly avoid them.