Effect of occurrence of infection-related never events on length of stay and hospital charges in patients undergoing radical neck dissection for head and neck cancer

Abstract

Objective: To estimate the impact of infection-related never events (postoperative pneumonia, Clostridium difficile infection, infection with microorganisms resistant to penicillin, postoperative infections, and decubitus ulcers) following radical neck dissections for head and neck cancers.

Study design: The 2008 Nationwide Inpatient Sample was used to select hospitalizations with HNC that underwent radical neck dissections. Predictor variables were occurrence of never events and other patient- and hospital-level factors. Outcome variables were hospitalization charges and length of stay (LOS). Regression analyses were used to measure the association between predictors and outcomes.

Results: Among 10,660 hospitalizations, prevalence of never events ranged from 0.2% to 5.0%. Mean hospitalization charge and LOS were $75,654 and 6.8 days, respectively. Never events were associated with 5.6-10.0 longer LOS and $49,153-$124,057 excess charges.

Conclusion: Occurrence of never events was associated with at least 5.6 longer hospital days and $49,153 charge compared with hospitalizations without a never event.