Abstract

INTRODUCTION: Emergency general surgery among cardiac surgery patients is increasingly common and consequential. We sought to characterize the true burden of emergency general surgery among hospitalized complex cardiac patients.METHODS: We performed a retrospective analysis of the 2016-2017 National Inpatient Sample. We included adult patients with a primary diagnosis of complex cardiac disease. We then compared patients who underwent emergency general surgery (GS-OR) with those who did not (non-GS-OR). The primary outcome was mortality; secondary outcomes included length of stay and hospitalization costs.RESULTS: We identified 10.2 million patients with a primary diagnosis of complex cardiac disease, of which 148,309 (1.4%) underwent GS-OR. Mortality rates were significantly higher in the GS-OR group (11.0% versus 5.0%, P<0.001). Among all cardiac patients, GS-OR was associated with 2.2 times increased odds of death (aOR: 2.2, P<0.001). GS-OR patients also had longer length of stays (14.1 versus 5.8d, P<0.001). Among all cardiac patients, GS-OR was associated with an 8.1-day longer length of stay (P<0.001). GS-OR patients were less often routinely discharged home (31.7% versus 45.3%, P<0.001) and incurred higher inpatient costs ($46,136 versus $16,303, P<0.001). Among all cardiac patients, GS-OR patients incurred $30,102 higher hospitalization costs (P<0.001).CONCLUSIONS: Emergency general surgery among cardiac surgery patients is associated with a greater than two-fold increase in mortality, longer length of stays, higher rates of nonroutine discharge, and higher hospitalization costs. Emergency general surgery complications account for 4.0% of total inpatient costs of cardiac surgery patients and merit further study.

View details for DOI 10.1016/j.jss.2022.10.016

View details for PubMedID 36368272