Colon and Rectal Surgery Is a “High Outlier” Specialty: A Case Study Using Postoperative Urinary Tract Infection

The incidence of major complications after colorectal resection remains high. Rates may even exceed those predicted by risk-adjustment models commonly in use. Colon and rectal resections account for the greatest share of all postoperative morbidity and mortality in the National Surgical Quality Improvement Program general surgery cohort, and a disproportionate share of the costs associated with postoperative complications. Infectious complications are particularly overrepresented, as surgical site and urinary tract infections are 2-3 times more common after colon and rectal surgery than other general surgery operations. Thus, surgeons with a specialty interest in colorectal surgery may be flagged as “high outliers” unless more is done to account for procedure-specific risk.