G. Mitchon1, A. Seifi1 1University Of Texas Health Science Center At San Antonio,Neuro Critical Care- Neurosurgery,San Antonio, TX, USA
Introduction:
Post-Operative Respiratory Failure (PORF) is a common complication leading to increased morbidity, mortality, hospital cost and length of stay. The purpose of this study is to determine the epidemiology and socioeconomic impacts on PORF as a Patient Safety Indicator (PSI) in the United States based on a robust database.
Methods:
This is a retrospective cohort study of hospital inpatient discharges that developed PORF during 2000-2011, identified through the Nationwide Inpatient Sample (NIS). Z-tests were performed using a modified version of version 4.4 of the PSI software and the NIS.
Results:
The incidence of PORF remained steady between 7-9/1000 elective surgeries each year. Rates of PORF were significantly higher in patients >65 years old (age 45-64: 6.26/1000 vs age 65+: 10.332/1000, P<0.001) and even higher for patients >85 years old (P<0.001). Males had a nearly 50% increase in PORF as compared to females (P<0.001). In contrast to age, higher income and having insurance demonstrated a negative correlation with PORF as evidenced by the facts that people in the lowest income quartile had significantly higher rates of PORF than all other income quartiles (P<0.001) and that people with private insurance had significantly lower rates than the uninsured and Medicare/Medicaid recipients (P<0.001). Hospitals in large metropolitan areas had significantly higher rates of PORF than did those in smaller municipalities (P<0.001).
Conclusion:
PORF is a common problem, affecting 7-9/1000 patients undergoing elective surgeries. The risk is even greater for elderly, male and low income patients. Further studies are needed to develop and validate objective grading criteria to prospectively identify patients at high risk.
