71.17 Comparing Outcomes & Costs in Body Contouring: Analyzing weekday v weekend admissions using the NIS

Posted on December 22, 2014

K. K. Tadisina1, K. Chopra2,3, D. P. Singh3  1University Of Illinois At Chicago,College Of Medicine,Chicago, IL, USA 2The Johns Hopkins Hospital,Department Of Plastic And Reconstructive Surgery,Baltimore, MD, USA 3University Of Maryland Medical Center,Division Of Plastic Surgery,Baltimore, MD, USA

Introduction:
Body contouring operations are a quickly becoming the most commonly performed operations by American plastic surgeons, mirroring the increase in bariatric surgery in the US over the last decade. Despite previous studies showing worse patient outcomes on weekend admissions for non-emergent cases (spine, breast, and hernia), there is no comparative data reported regarding body contouring procedures. This has implications especially now when physician handoffs are more frequent secondary to resident work hour restrictions. The authors’ aimed to determine whether body contouring surgery results in worse outcomes when performed on weekends versus weekdays.

Methods:
A serial cross-sectional study of body contouring patients was performed using the Nationwide Inpatient Sample (NIS) database from 2000-2010. Data were gathered using ICD-9 codes for reduction liposuction (86.83) for weekday and weekend admissions, including demographic, hospital charges, and patient outcomes were obtained.

Results:
A total of 49,706 hospital admission cases of inpatient body contouring admissions were examined over the 11 year period, 98% of which were on the weekday. 90% of patients were female, with admissions being elective in 85% of weekday cases versus 53% of weekend cases. When compared to weekday admissions, weekend admissions were associated with a statistically significant increase in hospital costs ($35,481, p<0.000) and increase in hospital length of stay (5.68 days, p<0.000). Mortality rates were found to be higher on weekend admission (3.7%) vs weekday (0.5%) as well.

Conclusion:
Although outcomes are multifactorial, in body contouring patients, weekday admission is associated with favorable outcomes in terms of LOS, mortality, and hospital charges.