The incremental cost of surgical site complications & infections across multiple surgical indications

Each year 2%–5% of patients undergoing inpatient surgery suffer a subsequent surgical site infection (SSI), It is estimated that between 160,000 and 300,000 SSIs occur each year in the United States¹. These and other complications, such as wound dehiscence, are of key concern to payers and clinicians. This is due to their impact on patients, the duration of hospital care they require, healthcare provider costs and margins. Prior research has shown that in 2005, SSI extended length of stay by 9.7 days and increased costs by $20,842².

Our analysis aimed to provide 2017 incremental length of stay, costs and readmission rates where SSI or other complications occur across multiple surgical indications.

Methods: The study was a retrospective analysis, conducted using the Premier database. A sample of patients (n=19007) who had a documented post-surgical complication (SSI, Disruption, Seroma, Hematoma, Edema) were matched with a sample with no corresponding complications for a direct comparison of cost and resource use. The analysis covered a broad range of surgical indications.

Results: Mean incremental cost of SSI across all indications was $14,945.21; an increase of 84%. SSI added on average 6.1 days to patients length of stay. None SSI complications also had significant implications, incurring incremental cost of $7,558.76 and increasing length of stay by 2.8 days. 34.4% of patients suffering post surgical complications had a subsequent hospital stay within 90 days of discharge.

Conclusions:

Across all surgical indications, SSI and other wound complications impose significant cost increases on a provider in the 3 months following surgery, prolong the overall hospital stay of patients and increase rates of readmission.