PMID- 37638082
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231023
IS  - 2772-6096 (Electronic)
IS  - 2772-6096 (Linking)
VI  - 7
DP  - 2023 Sep
TI  - Long-term healthcare use after postoperative complications: an analysis of linked 
      primary and secondary care routine data.
PG  - 100142
LID - 10.1016/j.bjao.2023.100142 [doi]
LID - 100142
AB  - BACKGROUND: Postoperative complications are associated with reduced long-term 
      survival. We characterise healthcare use changes after sentinel postoperative 
      complications. METHODS: We linked primary and secondary care records of patients 
      undergoing elective surgery at four East London hospitals (2012-7) with at least 
      90 days follow-up. Complication codes (wound infection, urinary tract infection, 
      pneumonia, new stroke, and new myocardial infarction) recorded within 90 days of 
      surgery were identified from primary or secondary care. Outcomes were change in 
      healthcare contact days in the 2 yr before and after surgery, and 2 yr mortality. 
      We report rate ratios (RaR) with 95% confidence intervals and adjusted for 
      baseline healthcare use and confounders using negative binomial regression. 
      RESULTS: We included 49 913 patients (median age 49 yr [inter-quartile range 
      IQR: 34-64]), 27 958 (56.0%) were female. Amongst 3883 (7.8%) patients with 
      complications (median age 58 [IQR: 43-72]), there were 18.4 days per year in 
      contact with healthcare before surgery and 25.3 days after surgery (RaR: 1.38 
      [1.37-1.39]). Patients without complications (median age 48 [IQR: 33-63]) had 
      12.3 days per year in contact with healthcare before surgery and 14.0 days after 
      surgery (RaR: 1.14 [1.14-1.15]). The adjusted incidence rate ratio of days in 
      contact with healthcare associated with complications was 1.67 (1.49-1.87). More 
      patients (391; 10.1%) with complications died within 2 yr than those without 
      (1428; 3.1%). CONCLUSIONS: Patients with postoperative complications are older 
      with greater healthcare use before surgery. However, their absolute and relative 
      increases in healthcare use after surgery are greater than patients without 
      complications.
CI  - (c) 2023 Published by Elsevier Ltd on behalf of British Journal of Anaesthesia.
FAU - Fowler, Alexander J
AU  - Fowler AJ
AD  - Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
AD  - Broomfield Hospital, Mid and South Essex NHS Foundation Trust, Chelmsford, Essex, 
      UK.
FAU - Brayne, Adam B
AU  - Brayne AB
AD  - Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
AD  - University Hospitals Plymouth, Derriford Road, Plymouth, Devon, UK.
FAU - Pearse, Rupert M
AU  - Pearse RM
AD  - Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
FAU - Prowle, John R
AU  - Prowle JR
AD  - Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK.
LA  - eng
PT  - Journal Article
DEP - 20230615
PL  - England
TA  - BJA Open
JT  - BJA open
JID - 9918419157906676
CIN - BJA Open. 2023 Oct 19;8:100233. PMID: 37869058
PMC - PMC10457466
OTO - NOTNLM
OT  - epidemiology
OT  - health services research
OT  - perioperative medicine
OT  - postoperative complications
OT  - primary care
EDAT- 2023/08/28 06:42
MHDA- 2023/08/28 06:43
PMCR- 2023/06/15
CRDT- 2023/08/28 04:59
PHST- 2022/12/13 00:00 [received]
PHST- 2023/03/24 00:00 [revised]
PHST- 2023/04/21 00:00 [accepted]
PHST- 2023/08/28 06:43 [medline]
PHST- 2023/08/28 06:42 [pubmed]
PHST- 2023/08/28 04:59 [entrez]
PHST- 2023/06/15 00:00 [pmc-release]
AID - S2772-6096(23)00021-7 [pii]
AID - 100142 [pii]
AID - 10.1016/j.bjao.2023.100142 [doi]
PST - epublish
SO  - BJA Open. 2023 Jun 15;7:100142. doi: 10.1016/j.bjao.2023.100142. eCollection 2023 
      Sep.