The association of health literacy and postoperative complications after colorectal surgery: A cohort study
Health literacy is a determinant of health. Few studies characterize its association with surgical outcomes. Retrospective cohort study of patients undergoing elective colorectal surgery 2015–2020. Health literacy assessed using Brief Health Literacy Screening Tool. Outcomes were postoperative compl...
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| Veröffentlicht in: | The American journal of surgery 2022-06, Vol.223 (6), p.1047-1052 |
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| container_title | The American journal of surgery |
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| creator | Theiss, Lauren M. Wood, Tara McLeod, Marshall C. Shao, Connie Santos Marques, Isabel Dos Bajpai, Swara Lopez, Elizabeth Duong, Anh M. Hollis, Robert Morris, Melanie S. Chu, Daniel I. |
| description | Health literacy is a determinant of health. Few studies characterize its association with surgical outcomes.
Retrospective cohort study of patients undergoing elective colorectal surgery 2015–2020. Health literacy assessed using Brief Health Literacy Screening Tool. Outcomes were postoperative complications, LOS, readmissions, mortality.
Of 552 patients, 46 (8.3%) had limited health literacy, 506 (91.7%) non-limited. Median age 57.7 years, 305 (55.1%) patients were female, 148 (26.8%) were Black. Limited patients had higher rates of overall complications (43.5% vs. 24.3%, p = 0.004), especially surgical site infections (21.7% vs. 11.3%, p = 0.04). Limited patients had longer LOS (5 vs 3.5 days, p = 0.006). Readmissions and mortality did not differ. On multivariable analysis, limited health literacy was independently associated with increased risk of complications (OR 2.03, p = 0.046), not LOS (IRR 1.05, p = 0.67).
Limited health literacy is associated with increased likelihood of complications after colorectal surgery. Opportunities exist for health literate surgical care to improve outcomes for limited health literacy patients.
•Limited health literacy patients have 2x higher odds of postoperative complications.•Limited health literacy patients are at the highest risk for surgical site infections.•Opportunities exist for more health literate care to optimize surgical outcomes. |
| doi_str_mv | 10.1016/j.amjsurg.2021.10.024 |
| format | Article |
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Retrospective cohort study of patients undergoing elective colorectal surgery 2015–2020. Health literacy assessed using Brief Health Literacy Screening Tool. Outcomes were postoperative complications, LOS, readmissions, mortality.
Of 552 patients, 46 (8.3%) had limited health literacy, 506 (91.7%) non-limited. Median age 57.7 years, 305 (55.1%) patients were female, 148 (26.8%) were Black. Limited patients had higher rates of overall complications (43.5% vs. 24.3%, p = 0.004), especially surgical site infections (21.7% vs. 11.3%, p = 0.04). Limited patients had longer LOS (5 vs 3.5 days, p = 0.006). Readmissions and mortality did not differ. On multivariable analysis, limited health literacy was independently associated with increased risk of complications (OR 2.03, p = 0.046), not LOS (IRR 1.05, p = 0.67).
Limited health literacy is associated with increased likelihood of complications after colorectal surgery. Opportunities exist for health literate surgical care to improve outcomes for limited health literacy patients.
•Limited health literacy patients have 2x higher odds of postoperative complications.•Limited health literacy patients are at the highest risk for surgical site infections.•Opportunities exist for more health literate care to optimize surgical outcomes.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2021.10.024</identifier><identifier>PMID: 34728069</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Cohort analysis ; Cohort Studies ; Colorectal Surgery ; Complications ; Demographics ; Elective Surgical Procedures - adverse effects ; Electronic health records ; Female ; Health education ; Health Literacy ; Humans ; Infections ; Length of Stay ; Literacy ; Male ; Medical records ; Middle Aged ; Mortality ; Patients ; Postoperative ; Postoperative Complications - etiology ; Postoperative period ; Retrospective Studies ; Surgery ; Surgical disparities ; Surgical outcomes ; Surgical site infections ; Thrombosis</subject><ispartof>The American journal of surgery, 2022-06, Vol.223 (6), p.1047-1052</ispartof><rights>2021 Elsevier Inc.</rights><rights>Copyright © 2021 Elsevier Inc. All rights reserved.</rights><rights>2021. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c495t-bb42b5eacd0348a37787719e06a87325e137875af166efe59b53c4e2fd82225a3</citedby><cites>FETCH-LOGICAL-c495t-bb42b5eacd0348a37787719e06a87325e137875af166efe59b53c4e2fd82225a3</cites><orcidid>0000-0002-5790-6984 ; 0000-0001-6432-4475 ; 0000-0001-9932-0271</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961021006176$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34728069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Theiss, Lauren M.</creatorcontrib><creatorcontrib>Wood, Tara</creatorcontrib><creatorcontrib>McLeod, Marshall C.</creatorcontrib><creatorcontrib>Shao, Connie</creatorcontrib><creatorcontrib>Santos Marques, Isabel Dos</creatorcontrib><creatorcontrib>Bajpai, Swara</creatorcontrib><creatorcontrib>Lopez, Elizabeth</creatorcontrib><creatorcontrib>Duong, Anh M.</creatorcontrib><creatorcontrib>Hollis, Robert</creatorcontrib><creatorcontrib>Morris, Melanie S.</creatorcontrib><creatorcontrib>Chu, Daniel I.</creatorcontrib><title>The association of health literacy and postoperative complications after colorectal surgery: A cohort study</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Health literacy is a determinant of health. Few studies characterize its association with surgical outcomes.
Retrospective cohort study of patients undergoing elective colorectal surgery 2015–2020. Health literacy assessed using Brief Health Literacy Screening Tool. Outcomes were postoperative complications, LOS, readmissions, mortality.
Of 552 patients, 46 (8.3%) had limited health literacy, 506 (91.7%) non-limited. Median age 57.7 years, 305 (55.1%) patients were female, 148 (26.8%) were Black. Limited patients had higher rates of overall complications (43.5% vs. 24.3%, p = 0.004), especially surgical site infections (21.7% vs. 11.3%, p = 0.04). Limited patients had longer LOS (5 vs 3.5 days, p = 0.006). Readmissions and mortality did not differ. On multivariable analysis, limited health literacy was independently associated with increased risk of complications (OR 2.03, p = 0.046), not LOS (IRR 1.05, p = 0.67).
Limited health literacy is associated with increased likelihood of complications after colorectal surgery. Opportunities exist for health literate surgical care to improve outcomes for limited health literacy patients.
•Limited health literacy patients have 2x higher odds of postoperative complications.•Limited health literacy patients are at the highest risk for surgical site infections.•Opportunities exist for more health literate care to optimize surgical outcomes.</description><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Colorectal Surgery</subject><subject>Complications</subject><subject>Demographics</subject><subject>Elective Surgical Procedures - adverse effects</subject><subject>Electronic health records</subject><subject>Female</subject><subject>Health education</subject><subject>Health Literacy</subject><subject>Humans</subject><subject>Infections</subject><subject>Length of Stay</subject><subject>Literacy</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Patients</subject><subject>Postoperative</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative period</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical disparities</subject><subject>Surgical outcomes</subject><subject>Surgical site infections</subject><subject>Thrombosis</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkctu1DAUhi0EokPhEUCW2LDJ4EscOyyoqoqbVIlNWVuOc9I4JHGwnZHm7XGYoQI2rKzzn-_c_CP0kpI9JbR6O-zNNMQ13O8ZYTRre8LKR2hHlawLqhR_jHaEEFbUFSUX6FmMQw4pLflTdMFLyRSp6h36ftcDNjF660xyfsa-wz2YMfV4dAmCsUds5hYvPia_5Di5A2Drp2V09ldFxKbLYNZGH8AmM-JtLQjHd_g6q70PCce0tsfn6Elnxggvzu8l-vbxw93N5-L266cvN9e3hS1rkYqmKVkjwNiW8FIZLqWSktZAKqMkZwIoz4owHa0q6EDUjeC2BNa1ijEmDL9E7099l7WZoLUwp2BGvQQ3mXDU3jj9d2Z2vb73B10TymRNc4M35wbB_1ghJj25aGEczQx-jZqJmhOmSqky-vofdPBrmPN5mlU5L2hFWabEibLBxxige1iGEr3ZqQd9tlNvdm5ytjPXvfrzkoeq3_5l4OoEQP7Pg4Ogo3UwW2jd5oVuvfvPiJ_NZrY0</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Theiss, Lauren M.</creator><creator>Wood, Tara</creator><creator>McLeod, Marshall C.</creator><creator>Shao, Connie</creator><creator>Santos Marques, Isabel Dos</creator><creator>Bajpai, Swara</creator><creator>Lopez, Elizabeth</creator><creator>Duong, Anh M.</creator><creator>Hollis, Robert</creator><creator>Morris, Melanie S.</creator><creator>Chu, Daniel I.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5790-6984</orcidid><orcidid>https://orcid.org/0000-0001-6432-4475</orcidid><orcidid>https://orcid.org/0000-0001-9932-0271</orcidid></search><sort><creationdate>20220601</creationdate><title>The association of health literacy and postoperative complications after colorectal surgery: A cohort study</title><author>Theiss, Lauren M. ; Wood, Tara ; McLeod, Marshall C. ; Shao, Connie ; Santos Marques, Isabel Dos ; Bajpai, Swara ; Lopez, Elizabeth ; Duong, Anh M. ; Hollis, Robert ; Morris, Melanie S. ; Chu, Daniel I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c495t-bb42b5eacd0348a37787719e06a87325e137875af166efe59b53c4e2fd82225a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Colorectal Surgery</topic><topic>Complications</topic><topic>Demographics</topic><topic>Elective Surgical Procedures - adverse effects</topic><topic>Electronic health records</topic><topic>Female</topic><topic>Health education</topic><topic>Health Literacy</topic><topic>Humans</topic><topic>Infections</topic><topic>Length of Stay</topic><topic>Literacy</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Patients</topic><topic>Postoperative</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative period</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical disparities</topic><topic>Surgical outcomes</topic><topic>Surgical site infections</topic><topic>Thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Theiss, Lauren M.</creatorcontrib><creatorcontrib>Wood, Tara</creatorcontrib><creatorcontrib>McLeod, Marshall C.</creatorcontrib><creatorcontrib>Shao, Connie</creatorcontrib><creatorcontrib>Santos Marques, Isabel Dos</creatorcontrib><creatorcontrib>Bajpai, Swara</creatorcontrib><creatorcontrib>Lopez, Elizabeth</creatorcontrib><creatorcontrib>Duong, Anh M.</creatorcontrib><creatorcontrib>Hollis, Robert</creatorcontrib><creatorcontrib>Morris, Melanie S.</creatorcontrib><creatorcontrib>Chu, Daniel I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Theiss, Lauren M.</au><au>Wood, Tara</au><au>McLeod, Marshall C.</au><au>Shao, Connie</au><au>Santos Marques, Isabel Dos</au><au>Bajpai, Swara</au><au>Lopez, Elizabeth</au><au>Duong, Anh M.</au><au>Hollis, Robert</au><au>Morris, Melanie S.</au><au>Chu, Daniel I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The association of health literacy and postoperative complications after colorectal surgery: A cohort study</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>223</volume><issue>6</issue><spage>1047</spage><epage>1052</epage><pages>1047-1052</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Health literacy is a determinant of health. Few studies characterize its association with surgical outcomes.
Retrospective cohort study of patients undergoing elective colorectal surgery 2015–2020. Health literacy assessed using Brief Health Literacy Screening Tool. Outcomes were postoperative complications, LOS, readmissions, mortality.
Of 552 patients, 46 (8.3%) had limited health literacy, 506 (91.7%) non-limited. Median age 57.7 years, 305 (55.1%) patients were female, 148 (26.8%) were Black. Limited patients had higher rates of overall complications (43.5% vs. 24.3%, p = 0.004), especially surgical site infections (21.7% vs. 11.3%, p = 0.04). Limited patients had longer LOS (5 vs 3.5 days, p = 0.006). Readmissions and mortality did not differ. On multivariable analysis, limited health literacy was independently associated with increased risk of complications (OR 2.03, p = 0.046), not LOS (IRR 1.05, p = 0.67).
Limited health literacy is associated with increased likelihood of complications after colorectal surgery. Opportunities exist for health literate surgical care to improve outcomes for limited health literacy patients.
•Limited health literacy patients have 2x higher odds of postoperative complications.•Limited health literacy patients are at the highest risk for surgical site infections.•Opportunities exist for more health literate care to optimize surgical outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>34728069</pmid><doi>10.1016/j.amjsurg.2021.10.024</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-5790-6984</orcidid><orcidid>https://orcid.org/0000-0001-6432-4475</orcidid><orcidid>https://orcid.org/0000-0001-9932-0271</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Cohort analysis Cohort Studies Colorectal Surgery Complications Demographics Elective Surgical Procedures - adverse effects Electronic health records Female Health education Health Literacy Humans Infections Length of Stay Literacy Male Medical records Middle Aged Mortality Patients Postoperative Postoperative Complications - etiology Postoperative period Retrospective Studies Surgery Surgical disparities Surgical outcomes Surgical site infections Thrombosis |
| title | The association of health literacy and postoperative complications after colorectal surgery: A cohort study |
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