ACS Logo Delay in surgical procedures seems to result in considerable harm for the patient admitted to a hospital. According to a recent study, prolonging elective surgical procedures after a patient has been admitted to the hospital elevates risk of infectious complications and increases hospital costs. Infection occurrence after surgical procedures appears as a major source of morbidity and expense.

In order to conduct the study, investigators thoroughly examined nationwide sample of 163,006 patients aged 40 years and above from 2003 to 2007. All the study subjects had developed postoperative complications after one of three high-volume elective surgical procedures. While 87,318 were diagnosed with coronary artery bypass graft (CABG) procedures and 46,728 with colon resections, 28,960 had lung resections. Infectious complications such as pneumonia, urinary tract infections, postoperative sepsis and surgical site infections were registered. For each type of procedure, infection rates apparently heightened from those performed on the day of admission to those performed one, two to five, and six to 10 days later.

Todd R. Vogel, MD, MPH, FACS, assistant professor of surgery at the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, lead study author, shared, “Multiple factors can contribute to postsurgical complications, including age and coexisting health issues. This analysis, however, confirms a direct correlation between delaying procedures and negative patient outcomes. As pay-for-performance models become increasingly prevalent, it will be imperative for hospitals to consider policies aimed at preventing delays and thereby reducing infection rates.”

Scientists note that the total infection rates after CABG rose from 5.7 percent on the day of admission to 18.2 percent at six to 10 days. Similar increases were registered after colon resection and also on completion of lung resection. It appeared that the delays inflated total hospital costs dramatically. Mean cost apparently heightened delays for all CABG, colon resections as well as lung resections. Factors linked with in-hospital procedure delays probably encompassed advanced age (80 years and older), female gender, minority status, and existing health issues including congestive heart failure, chronic pulmonary disease, and renal failure. Presumably, postoperative complications in CABG and colon resection were correlated with urinary tract infections and pneumonia. CABG procedures and lung resections were postponed for more than five days.

The study is published in the December issue of the Journal of the American College of Surgeons.