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Unhealthy alcohol and drug use is associated with an increased length of stay and hospital cost in patients undergoing major upper gastrointestinal and pancreatic oncologic resections.
- Source :
-
Surgery [Surgery] 2021 Mar; Vol. 169 (3), pp. 636-643. Date of Electronic Publication: 2020 Sep 18. - Publication Year :
- 2021
-
Abstract
- Background: Few studies evaluate the impact of unhealthy alcohol and drug use on the risk and severity of postoperative outcomes after upper gastrointestinal and pancreatic oncologic resections.<br />Methods: The National Inpatient Sample was queried to identify patients undergoing total gastrectomy, esophagectomy, total pancreatectomy, and pancreaticoduodenectomy between 2012 and 2015. Unhealthy alcohol and drug use was assessed by the International Classification of Diseases, Ninth Revision, and National Inpatient Sample coder designation. Multivariable regression was used to identify associations between alcohol and drug use and postoperative complication, duration of stay, hospital cost, and mortality.<br />Results: In the study, 59,490 patients met inclusion criteria; 2,060 (3.5%) had unhealthy alcohol use; 1,265 (2.1%) had unhealthy drug use. Postoperative complication rates were higher in patients with alcohol and drug use than in abstainers (67.5% vs 62.8% vs 57.2%; P < .01). On multivariable regression, alcohol use was independently associated with increased risk of a nonwithdrawal complication (odds ratio 1.33 [1.05, 1.68]), and alcohol and drug use were independently associated with increased length of stay (1.54 [0.12, 2.96]) and 2.22 [0.90, 3.55] days) and cost ($5,471 [$60, $10,881] and $4,022 [$402, $7,643]), but not mortality.<br />Conclusion: Unhealthy substance use is associated with increased rates of postoperative complications, prolonged length of stay, and costs in patients undergoing major upper gastrointestinal and pancreatic oncologic resections. Screening and abstinence interventions should be incorporated into the preoperative care pathways for these patients.<br /> (Published by Elsevier Inc.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Factor Analysis, Statistical
Female
Gastrointestinal Neoplasms surgery
Humans
Male
Middle Aged
Outcome Assessment, Health Care
Pancreatic Neoplasms surgery
Postoperative Complications
Public Health Surveillance
Alcoholism epidemiology
Alcoholism etiology
Gastrointestinal Neoplasms complications
Hospital Costs
Length of Stay
Pancreatic Neoplasms complications
Substance-Related Disorders epidemiology
Substance-Related Disorders etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-7361
- Volume :
- 169
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 32951904
- Full Text :
- https://doi.org/10.1016/j.surg.2020.07.059