PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Obese patients at much greater risk for costly surgical-site infections

Infections lead to higher bills, extended hospital stays, risk of readmission

2011-05-17
(Press-News.org) Obese patients undergoing colon surgery are 60 percent more likely to develop dangerous and costly surgical-site infections than their normal-weight counterparts, new Johns Hopkins research suggests.

These infections, according to findings published in the journal Archives of Surgery, cost an average of $17,000 more per patient, extend hospital stays and leave patients at a three-times greater risk of hospital readmission.

"Obesity is a leading risk factor for surgical-site infections, and those infections truly tax the health care system," says Elizabeth C. Wick, M.D., an assistant professor of surgery at the Johns Hopkins University School of Medicine and the lead author of the study. "The burdens of caring for obese patients need to be better recognized."

To conduct the study, the Johns Hopkins team analyzed claims data from eight different Blue Cross and Blue Shield insurance plans for partial or total colon removal surgeries performed on adults ages 18 to 64 between 2002 and 2008. They identified 7,020 patients, 1,243 of whom were obese. The researchers looked at 30-day infection rates and calculated total costs from all health care claims for 90 days following surgery.

Colon surgery — performed to treat colon cancer, diverticulitis and inflammatory bowel disease — costs roughly $300 more per obese patient, whether an infection occurred or not. Obese patients also had slightly longer hospital stays, regardless of infection.

The average cost of caring for a patient with a surgical-site infection was $32,182 compared to $15,131 for each patient who didn't get infected. Those with infections stayed in the hospital for an average of 9.5 days compared to 8.1 days for those who did not contract one. The probability of hospital readmission in infected patients was 27.8 percent versus 6.8 percent in non-infected patients. When they had to be readmitted, those who had surgical-site infections stayed an average of two days longer than those without.

Not only are these findings relevant to physicians who need to pay special heed to infections in heavier patients but, the authors argue, to policymakers who plan to mandate public reporting of hospitals' surgical-site infection rates. Some insurers, meanwhile, have begun to withhold payment from hospitals when patients develop these complications and other insurers have discussed similar penalties. None of these plans take into account the higher infection rates found in obese surgical patients, Wick says.

Wick and her colleagues worry that punishing hospitals for surgical-site infections in obese patients could lead to discrimination, with surgeons shying away from operating on the heaviest patients for fear of financial loss and public shaming. Hospitals in 2012 will be required to publicly release surgical-site infection rates. If a hospital treated fewer obese patients, she notes, it would likely have fewer reportable infections.

"Pay-for-performance policies in surgery should account for the increased risk of infection and the cost of caring for this population," she says. "Failure to consider these differences can lead to perverse incentives that may penalize surgeons who care for obese patients and may even affect obese patients' access to surgery."

Thirty-four percent of adults in the United States are now estimated to be obese (those with a body mass index above 30), up from just 15 percent a decade ago.

### Other study authors, all from Johns Hopkins, include Kenzo Hirose, M.D.; Andrew D. Shore, Ph.D.; Jeanne M. Clark, M.D., M.P.H.; Susan L. Gearhart, M.D.; Jonathan Efron, M.D.; and Martin A. Makary, M.D., M.P.H.

For more information: http://www.hopkinsmedicine.org/surgery/faculty/Wick


ELSE PRESS RELEASES FROM THIS DATE:

Study links obesity to increased risk of developing postoperative infection following colon surgery

2011-05-17
Obese patients appear to have a significantly increased risk of developing a surgical site infection after colectomy (procedure involving either partial or full removal of the colon), and the presence of infection increases the cost associated with the procedure, according to a report published online today that will appear in the September issue of Archives of Surgery, one of the JAMA/Archives journals. Surgical site infection (SSI) is considered to be one of the best available measures of quality in surgery, and health care centers are starting to be financially penalized ...

Patients referred to dermatologists skin lesions evaluations also found to have other skin cancers

2011-05-17
Among patients referred by non-dermatologists to dermatologists for evaluation of skin lesions suspected of being malignant, only apparently one-fifth were found to be cancerous, although dermatologists identified and biopsied other incidental lesions, approximately half of which were malignant, according to a report in the May issue of Archives of Dermatology, one of the JAMA/Archives journals. "More than one million skin cancers are diagnosed annually in the United States , with one in five Americans developing skin cancer during their lifetime," the authors write as ...

Reminding surgical staff of phlebotomy costs appears to affect utilization

2011-05-17
Surgical house staff and attending physicians who are reminded about the charges for ordering daily blood drawing for routine blood work appear to reduce the amount of routine blood tests ordered and the charges for these laboratory tests, according to a report in the May issue of Archives of Surgery, one of the JAMA/Archives journals. "The use of laboratory tests has been rapidly increasing over the past few decades to the point where phlebotomy is a substantial proportion of hospital expenditure, and much of it is unwarranted," state the authors. As background, they ...

Objective evidence of skin infestation lacking in patients with diagnosis of delusional infestation

2011-05-17
Among patients with a diagnosis of delusional skin infestation, neither biopsies nor patient-provided specimens provided objective evidence of skin infestation, according to a report posted online today that will be published in the September issue of Archives of Dermatology, one of the JAMA/Archives journals. Delusional infestation is a condition in which patients steadfastly yet mistakenly believe that pathogens are infesting their skin. Sometimes, patients believe their skin is literally crawling with bugs, worms, or germs, which is also known as "delusions of parasitosis." ...

Propranolol associated with improvement in size and color of head and neck hemangiomas in children

2011-05-17
The beta-blocker propranolol appears to be associated with reducing the size and color of hemangiomas of the head and neck in a pediatric population, according to a report in the May issue of Archives of Otolaryngology–Head and Neck Surgery, one of the JAMA/Archives journals. According to background information in the article, hemangiomas are tumors that appear by the age of 2 months, affecting up to 10 percent of full-term white infants. These lesions can be benign, or can affect functions such as the ability to see or on occasion can be life-threatening if they occur ...

Nasal steroid spray may not help resolve dysfunction of the ear's eustachian tubes

2011-05-17
For patients with eustachian tube dysfunction (ETD), steroids administered by a nasal spray may be ineffective, according to a report in the May issue of Archives of Otolaryngology–Head and Neck Surgery, one of the JAMA/Archives journals. The eustachian tubes connect the middle ear, the upper part of the throat and the ends of the nasal passages. Eustachian tube dysfunction may contribute to fluid collection in the middle ear (otitis media with effusion, or OME) or negative middle ear pressure (NMEP). Presently there is no gold-standard single treatment for this condition, ...

Employees don't always share well with others, says new paper exposing 'knowledge hiding'

2011-05-17
Toronto - Why isn't knowledge transfer happening more often in companies spending money on it? Maybe it's because their staff don't always want to share. "We've had years of research in organizations about the benefits of knowledge-sharing but an important issue is the fact that people don't necessarily want to share their knowledge," says David Zweig, a professor of organizational behaviour and human resources management at the University of Toronto's Rotman School of Management and the University of Toronto at Scarborough. His paper, co-authored with Catherine ...

Surgical procedure appears to enhance smiles in children with facial paralysis

2011-05-17
Transferring a segment of muscle from the thigh appears to help restore the ability to smile in children with facial paralysis just as it does in adults, according to a report in the May issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals. The article is part of a theme issue focusing on facial plastic surgery in the pediatric population. Facial paralysis often disrupts the ability to smile. In pediatric patients, this can be especially problematic, according to background information in the article. Surgery to repair the affected area may generate ...

Freedom in the swamp: Unearthing the secret history of the Great Dismal Swamp

Freedom in the swamp: Unearthing the secret history of the Great Dismal Swamp
2011-05-17
It's the year 1800. You're a slave in southeast Virginia. You manage to escape. Your freedom is only going to last as long as you can hide. Where do you go? Would you believe the Great Dismal Swamp? According to Dan Sayers, assistant professor of anthropology and an historical archaeologist at American University, that's exactly where you could have gone for immediate sanctuary. "There are interesting parallels. What was once more of a human refuge is now a natural refuge," said Sayers of the swamp, which officially became the Great Dismal Swamp National Wildlife ...

Abcc10 may be effective in extending the effectiveness of anticancer drugs

2011-05-17
PHILADELPHIA, PA (May 16, 2011)––Today's anticancer drugs often work wonders against malignancies, but sometimes tumors become resistant to the effects of such drugs, and treatment fails. Medical researchers would like to find ways of counteracting such resistance, but first they must understand why and how it happens. New findings by Fox Chase Cancer Center researchers identify one protein, Abcc10 (also known as Mrp7), as being intimately involved in resistance to certain drugs used to treat breast, ovarian, lung, and other cancers. The results suggest that blunting the ...

LAST 30 PRESS RELEASES:

UBC enzyme technology clears first human test toward universal donor organs for transplantation

Birds’ vocal warnings provide new insight into the origins of language

Breakthrough results from elephant herpesvirus trial find vaccine to be safe

Final step in the biosynthesis of iridoids elucidated

New antibiotic targets IBD — and AI predicted how it would work before scientists could prove it

Glioblastomas affect much more than just the brain

Researchers uncover why mental maps fade with age

New mechanism revealed: How leukemia cells trick the immune system

Genetic map reveals influence of DNA on metabolism

Researchers use ultrasound holograms to influence brain networks

Unique videos show how trawling restrictions brings back life to the sea

Whooping cough can be fatal in young infants, experts warn

Knee-d for excellence: New regional training hub keeps surgeons sharp for ageing population

The Lancet: Billions lack access to healthy diets as food systems drive climate and health crises, but sustainable, equitable solutions are within reach, says new EAT-Lancet report

Countries with highest reported levels of hearing loss have lowest use of hearing aids

Early medical abortion at home up to 12 weeks is safe, effective, and comparable to hospital care

New approach to gravitational wave detection opens the Milli-Hz Frontier

Rice membrane extracts lithium from brines with greater speed, less waste

Exercise lowers disease risk. This researcher wants to understand how

Hurricane evacuation patterns differ based on where the storm hits

Stem Cell Reports welcomes new members to its Editorial Board

Researchers develop molecular qubits that communicate at telecom frequencies

Mayo Clinic awarded up to $40 million by ARPA-H for pioneering air safety research

People with Down syndrome have early neuroinflammation

CNIO researchers create the “human repairome”, a catalogue of DNA “scars” that will help define personalized cancer treatments

Strengthening biosecurity screening for genes that encode proteins of concern

Global wildfire disasters are growing in frequency and cost

Wildfire management: Reactive response and recovery, or proactive mitigation and prevention

Phosphine detected in the atmosphere of a low-temperature brown dwarf

Scientists develop rapid and scalable platform for in planta directed evolution

[Press-News.org] Obese patients at much greater risk for costly surgical-site infections
Infections lead to higher bills, extended hospital stays, risk of readmission