Abstract

Objective To evaluate outcomes after nonobstetric surgical procedures in pregnant patients. Methods We conducted a retrospective cohort study of 5591 pregnant women who underwent nonobstetric surgical procedures using Taiwan's National Health Insurance Research Database 2008-2012 claims data. Using a propensity score matching procedure, 22,364 nonpregnant women were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of postoperative complications and in-hospital mortality associated with pregnancy. Results Pregnant women had higher risks of postoperative septicemia (OR=1.75; 95% CI, 1.47-2.07), pneumonia (OR=1.47; 95% CI, 1.01-2.13), urinary tract infection (OR=1.29; 95% CI, 1.08-1.54), and in-hospital mortality (OR=3.94; 95% CI, 2.62-5.92) compared with nonpregnant women. Pregnant women also had longer hospital stays and higher medical expenditures after nonobstetric surgical procedures than controls. Higher rates of postoperative adverse events in pregnant women receiving nonobstetric surgery were noted in all age groups. Conclusion Surgical patients with pregnancy showed more adverse events, with a risk of in-hospital mortality approximately 4-fold higher after nonobstetric surgery compared with nonpregnant patients. These findings suggest the urgent need to revise the protocols for postoperative care for this population.

Original languageEnglish
Pages (from-to)1166-1172
Number of pages7
JournalMayo Clinic Proceedings
Volume91
Issue number9
DOIs
Publication statusPublished - Sep 1 2016

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Odds Ratio
Pregnant Women
Hospital Mortality
Pregnancy
Propensity Score
Postoperative Care
National Health Programs
Health Expenditures
Taiwan
Urinary Tract Infections
Length of Stay
Sepsis
Pneumonia
Cohort Studies
Retrospective Studies
Age Groups
Logistic Models
Databases
Research
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{e88fe4acea574a23bf971c5d9928ed5b,
title = "Outcomes After Nonobstetric Surgery in Pregnant Patients: A Nationwide Study",
abstract = "Objective To evaluate outcomes after nonobstetric surgical procedures in pregnant patients. Methods We conducted a retrospective cohort study of 5591 pregnant women who underwent nonobstetric surgical procedures using Taiwan's National Health Insurance Research Database 2008-2012 claims data. Using a propensity score matching procedure, 22,364 nonpregnant women were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95{\%} CIs of postoperative complications and in-hospital mortality associated with pregnancy. Results Pregnant women had higher risks of postoperative septicemia (OR=1.75; 95{\%} CI, 1.47-2.07), pneumonia (OR=1.47; 95{\%} CI, 1.01-2.13), urinary tract infection (OR=1.29; 95{\%} CI, 1.08-1.54), and in-hospital mortality (OR=3.94; 95{\%} CI, 2.62-5.92) compared with nonpregnant women. Pregnant women also had longer hospital stays and higher medical expenditures after nonobstetric surgical procedures than controls. Higher rates of postoperative adverse events in pregnant women receiving nonobstetric surgery were noted in all age groups. Conclusion Surgical patients with pregnancy showed more adverse events, with a risk of in-hospital mortality approximately 4-fold higher after nonobstetric surgery compared with nonpregnant patients. These findings suggest the urgent need to revise the protocols for postoperative care for this population.",
author = "Huang, {Shih Yu} and Lo, {Po Han} and Liu, {Wei Min} and Cherng, {Yih Giun} and Yeh, {Chun Chieh} and Chen, {Ta Liang} and Liao, {Chien Chang}",
year = "2016",
month = "9",
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doi = "10.1016/j.mayocp.2016.06.021",
language = "English",
volume = "91",
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journal = "Mayo Clinic Proceedings",
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T1 - Outcomes After Nonobstetric Surgery in Pregnant Patients

T2 - A Nationwide Study

AU - Huang, Shih Yu

AU - Lo, Po Han

AU - Liu, Wei Min

AU - Cherng, Yih Giun

AU - Yeh, Chun Chieh

AU - Chen, Ta Liang

AU - Liao, Chien Chang

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Objective To evaluate outcomes after nonobstetric surgical procedures in pregnant patients. Methods We conducted a retrospective cohort study of 5591 pregnant women who underwent nonobstetric surgical procedures using Taiwan's National Health Insurance Research Database 2008-2012 claims data. Using a propensity score matching procedure, 22,364 nonpregnant women were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of postoperative complications and in-hospital mortality associated with pregnancy. Results Pregnant women had higher risks of postoperative septicemia (OR=1.75; 95% CI, 1.47-2.07), pneumonia (OR=1.47; 95% CI, 1.01-2.13), urinary tract infection (OR=1.29; 95% CI, 1.08-1.54), and in-hospital mortality (OR=3.94; 95% CI, 2.62-5.92) compared with nonpregnant women. Pregnant women also had longer hospital stays and higher medical expenditures after nonobstetric surgical procedures than controls. Higher rates of postoperative adverse events in pregnant women receiving nonobstetric surgery were noted in all age groups. Conclusion Surgical patients with pregnancy showed more adverse events, with a risk of in-hospital mortality approximately 4-fold higher after nonobstetric surgery compared with nonpregnant patients. These findings suggest the urgent need to revise the protocols for postoperative care for this population.

AB - Objective To evaluate outcomes after nonobstetric surgical procedures in pregnant patients. Methods We conducted a retrospective cohort study of 5591 pregnant women who underwent nonobstetric surgical procedures using Taiwan's National Health Insurance Research Database 2008-2012 claims data. Using a propensity score matching procedure, 22,364 nonpregnant women were selected for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of postoperative complications and in-hospital mortality associated with pregnancy. Results Pregnant women had higher risks of postoperative septicemia (OR=1.75; 95% CI, 1.47-2.07), pneumonia (OR=1.47; 95% CI, 1.01-2.13), urinary tract infection (OR=1.29; 95% CI, 1.08-1.54), and in-hospital mortality (OR=3.94; 95% CI, 2.62-5.92) compared with nonpregnant women. Pregnant women also had longer hospital stays and higher medical expenditures after nonobstetric surgical procedures than controls. Higher rates of postoperative adverse events in pregnant women receiving nonobstetric surgery were noted in all age groups. Conclusion Surgical patients with pregnancy showed more adverse events, with a risk of in-hospital mortality approximately 4-fold higher after nonobstetric surgery compared with nonpregnant patients. These findings suggest the urgent need to revise the protocols for postoperative care for this population.

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