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. 2022 Jun;223(6):1047-1052.
doi: 10.1016/j.amjsurg.2021.10.024. Epub 2021 Oct 16.

The association of health literacy and postoperative complications after colorectal surgery: A cohort study

Lauren M Theiss  1 , Tara Wood  1 , Marshall C McLeod  1 , Connie Shao  1 , Isabel Dos Santos Marques  1 , Swara Bajpai  1 , Elizabeth Lopez  1 , Anh M Duong  1 , Robert Hollis  1 , Melanie S Morris  1 , Daniel I Chu  2
Affiliations

The association of health literacy and postoperative complications after colorectal surgery: A cohort study

Lauren M Theiss et al. Am J Surg. 2022 Jun.

Abstract

Background: Health literacy is a determinant of health. Few studies characterize its association with surgical outcomes.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Colorectal surgery; Health literacy; Surgical disparities; Surgical outcomes.

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Conflict of interest statement

No authors have any financial or commercial conflicts of interest related to this study.

Figures

Figure 1.
Figure 1.
Breakdown and timing of all complication occurrences for patients with limited and non-limited health literacy. Bubble size reflects relative number of occurrences of each complication type. DVT indicates deep venous thrombosis; PTE, pulmonary thromboembolism; C diff, clostridium difficile infection; CVA, cerebrovascular accident; UTI, urinary tract infection. 1 Complication presentation prior to discharge from index surgical encounter 2 Complication presentation after discharge from index surgical encounter
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Comment in

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