Analysis of risk factors for elective surgery complications in a cancer specialty hospital based on propensity score matching

BMC Health Serv Res. 2025 Jul 1;25(1):834. doi: 10.1186/s12913-025-13065-1.

Abstract

Objective: To analyze the incidence of complications in elective surgery patients at a certain cancer hospital, explore the influencing factors, and assess their impact on length of hospital stay and hospitalization costs, providing a reference for improving medical quality and reducing healthcare costs.

Methods: A retrospective study was conducted, collecting clinical data of elective surgery patients from January 1, 2022, to December 31, 2023. A dataset was constructed based on propensity score matching (PSM), and the disease burden caused by surgical complications was calculated. Logistic regression analysis was used to identify factors influencing the occurrence of surgical complications.

Results: Among 38,132 elective surgery patients, 300 developed complications (incidence rate: 0.79%). After propensity score matching, the median length of stay for patients with complications was 19 days, significantly higher than the 8 days for those without complications (P < 0.001), and the median hospitalization costs increased by 2.35 times (P < 0.001). Univariate and multivariate analyses showed that surgical duration, minimally invasive surgery, and ASA classification significantly influenced the occurrence of complications (P < 0.05).

Conclusion: Surgical complications significantly increase the length of hospital stay and hospitalization costs. Perioperative management should focus on risk factors such as older age, longer surgery time, higher incision level, and higher ASA score. Personalized interventions can reduce the risk of complications, thereby optimizing medical quality and resource utilization efficiency.

Keywords: Hospital stay; Hospitalization costs; Propensity score matching; Surgical complications.