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Article: Postoperative urinary tract infection and short-term outcomes and costs in head and neck cancer surgery

TitlePostoperative urinary tract infection and short-term outcomes and costs in head and neck cancer surgery
Authors
Issue Date2013
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ohns
Citation
Otolaryngology - Head and Neck Surgery, 2013, v. 148 n. 4, p. 602-610 How to Cite?
AbstractOBJECTIVES: Catheter-associated urinary tract infections (UTIs) have been identified as a preventable 'never event' by the Centers for Medicare and Medicaid Services. We sought to determine the relationship between UTI and in-hospital mortality, postoperative complications, length of stay, and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis using cross-tabulations and multivariate regression modeling. SETTING: The Nationwide Inpatient Sample database. SUBJECTS AND METHODS: Discharge data for 93,663 patients who underwent an ablative procedure for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2003-2008 were analyzed. RESULTS: Urinary tract infection was diagnosed in 2% of patients, with catheter-associated UTI coded in only 20 patients. Patients with UTI were more likely to be older than 80 years (odds ratio [OR], 3.3; P = .008), be female (OR, 1.9; P < .001), have advanced comorbidity (OR, 1.8; P < .012), undergo major surgical procedures (OR, 1.7; P = .001), and have predisposing bladder and prostate conditions (OR, 3.8; P < .001), surgical complications (OR, 2.3; P < .001), and acute medical complications (OR, 3.1; P < .001). Urinary tract infection was associated with significantly increased length of hospitalization and hospital-related costs, after controlling for all other variables. CONCLUSION: Urinary tract infection is unusual in HNCA surgical patients but is more common with extent of surgery and age and is significantly associated with postoperative complications, length of hospitalization, and hospital-related costs. Catheter-associated UTI is likely underestimated because of difficulty in distinguishing between a catheter-associated UTI and postoperative UTI in patients undergoing major surgical procedures, who routinely undergo perioperative urinary catheterization. Patients with HNCA are a high-risk group for this 'never event,' particularly as the population ages.
Persistent Identifierhttp://hdl.handle.net/10722/200933
ISSN
2015 Impact Factor: 2.021
2015 SCImago Journal Rankings: 1.176
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChan, JYWen_US
dc.contributor.authorSemenov, YRen_US
dc.contributor.authorGourin, CGen_US
dc.date.accessioned2014-08-21T07:07:38Z-
dc.date.available2014-08-21T07:07:38Z-
dc.date.issued2013en_US
dc.identifier.citationOtolaryngology - Head and Neck Surgery, 2013, v. 148 n. 4, p. 602-610en_US
dc.identifier.issn0194-5998en_US
dc.identifier.urihttp://hdl.handle.net/10722/200933-
dc.description.abstractOBJECTIVES: Catheter-associated urinary tract infections (UTIs) have been identified as a preventable 'never event' by the Centers for Medicare and Medicaid Services. We sought to determine the relationship between UTI and in-hospital mortality, postoperative complications, length of stay, and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis using cross-tabulations and multivariate regression modeling. SETTING: The Nationwide Inpatient Sample database. SUBJECTS AND METHODS: Discharge data for 93,663 patients who underwent an ablative procedure for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2003-2008 were analyzed. RESULTS: Urinary tract infection was diagnosed in 2% of patients, with catheter-associated UTI coded in only 20 patients. Patients with UTI were more likely to be older than 80 years (odds ratio [OR], 3.3; P = .008), be female (OR, 1.9; P < .001), have advanced comorbidity (OR, 1.8; P < .012), undergo major surgical procedures (OR, 1.7; P = .001), and have predisposing bladder and prostate conditions (OR, 3.8; P < .001), surgical complications (OR, 2.3; P < .001), and acute medical complications (OR, 3.1; P < .001). Urinary tract infection was associated with significantly increased length of hospitalization and hospital-related costs, after controlling for all other variables. CONCLUSION: Urinary tract infection is unusual in HNCA surgical patients but is more common with extent of surgery and age and is significantly associated with postoperative complications, length of hospitalization, and hospital-related costs. Catheter-associated UTI is likely underestimated because of difficulty in distinguishing between a catheter-associated UTI and postoperative UTI in patients undergoing major surgical procedures, who routinely undergo perioperative urinary catheterization. Patients with HNCA are a high-risk group for this 'never event,' particularly as the population ages.en_US
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/ohnsen_US
dc.relation.ispartofOtolaryngology - Head and Neck Surgeryen_US
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in <Journal title>. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in PUBLICATION, [VOL#, ISSUE#, (DATE)] DOI#en_US
dc.subject.meshCatheter-Related Infections - economicsen_US
dc.subject.meshHead and Neck Neoplasms - economics - surgeryen_US
dc.subject.meshPostoperative Complications - economicsen_US
dc.subject.meshUrinary Catheterization - adverse effectsen_US
dc.subject.meshUrinary Tract Infections - economics - etiologyen_US
dc.titlePostoperative urinary tract infection and short-term outcomes and costs in head and neck cancer surgeryen_US
dc.typeArticleen_US
dc.identifier.emailChan, JYW: jywchan1@hku.hken_US
dc.identifier.authorityChan, JYW=rp01314en_US
dc.identifier.doi10.1177/0194599812474595en_US
dc.identifier.pmid23348871en_US
dc.identifier.hkuros231981en_US
dc.identifier.volume148en_US
dc.identifier.issue4en_US
dc.identifier.spage602en_US
dc.identifier.epage610en_US
dc.identifier.isiWOS:000318362800013-
dc.publisher.placeUnited Statesen_US

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