Post-op infections most costly and deadly injuries

Medical injuries during hospitalization result in longer hospital stays, higher costs, and a high number of deaths, according to a study from the Agency for Healthcare Research and Quality (AHRQ) in Rockville, MD. Postoperative bloodstream infections had the most serious consequences, resulting in hospital stays of almost 11 days longer than normal, added costs of $57,727, and an increased risk of death after surgery of 21.9%.

Based on these data, researchers estimate that 3,000 Americans die each year from postoperative bloodstream infections. The next most serious event was postoperative reopening of a surgical incision, with 9.4 excess days, $40,323 in added costs, and a 9.6% increase in the risk of death. This equates to an estimated 405 deaths from reopening of surgical incisions annually. Birth and obstetric trauma, in contrast, resulted in little or no excess length of stay, cost, or increase in the risk of death.

AHRQ researchers reported that the impact of medical injuries varies substantially.1 The one common theme was they all have the potential for tremendous liability and expense, says AHRQ director Carolyn M. Clancy, MD. "This study gives us the first direct evidence that medical injuries pose a real threat to the American public and increase the costs of health care," she says. "The nation’s hospitals can use this information to enhance the efforts they already are taking to reduce medical errors and improve patient safety."

The study used AHRQ’s Patient Safety Indicators and Healthcare Cost and Utilization Project’s National Inpatient Sample data to identify medical injures in 7.45 million hospital discharges from 994 acute care hospitals across 28 states in 2000. The study provides, for the first time, specific estimates for excess length of stay, charges, and the risk of death for each of 18 of the 20 AHRQ Patient Safety Indicators.


1. Zhan C, Miller M. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA 2003; 290:1,868-1,874.