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Background Longer surgical total procedure times (TPT) have been associated with increased postoperative complications. It is unclear what the effect of TPT is on length-of-stay (LOS) or 30-day readmission rate (RAR). Methods We performed a retrospective study of patients undergoing knee arthroplasty (KA), colectomy, and craniectomy at NorthShore University HealthSystem from 1/2007 to 12/2013. Clinical data were extracted from the Data Warehouse and charts were reviewed. We standardized surgery times for each procedure and categorized into two groups: times <75‰ (short procedures) vs. times >75‰ (long procedures). We used χ 2 and t-test to compare categorical and continuous variables. We performed multivariate logistic regression for predictors of surgical site infection (SSI). Results In univariate analyses, long procedures were associated with higher incidence of fevers, SSI, longer LOS, and 30-day RAR (Table 1). TPT was not associated with other postoperative complications. TPT remained an independent predictor of SSI in multivariate (MV) analysis (Table 2). Conclusion High TPT was associated with increased SSI, LOS, and 30-day RAR. Understanding variation in TPT may help decrease SSI and healthcare utilization.Table 1: Variables Stratified by (TPT) Characteristic N (%) Short N = 5920 Long N = 1980 P-value Fever ≥ 100.4 1042 (17.6%) 450 (22.7%) * Body mass index ≥ 35 1143 (19.7%) 519 (26.6%) * Female 3867 (65.3%) 1117 (56.4%) * Surgery KA 4788 (80.9%) 1604 (81.0%) 0.99 Colectomy 467 (7.9%) 155 (7.8%) Craniectomy 665 (11.2%) 221 (11.2%) Complication 420 (7.1%) 154 (7.8%) 0.31 Urinary tract infection 76 (1.3%) 26 (1.3%) 0.92 Pneumonia 75 (1.3%) 28 (1.4%) 0.62 SSI 67 (1.1%) 41 (2.1%) * Venous thromboembolism 174 (2.9%) 61 (3.1%) 0.75 SSI w/in 30 day of discharge 84 (1.4%) 48 (2.4%) * Mean LOS, days (SD) 3.69 (2.89) 4.05 (3.38) * 30d RAR 277 (4.7%) 142 (7.2%) * *P-value < 0.01Table 2: MV logistic regression€ of SSI within 30-day of discharge OR (95% CI) P-value Age 0.99 (0.98–1.01) 0.97 Female 1.21 (0.84–1.75) 0.31 Surgery KA Ref. * Colectomy 70.2 (36.6–134.6) Craniectomy 20.3 (10.0–41.0) TPT > 75 th %ile 1.59 (1.08–2.33) 0.02 Fever > 100.4 4.10 (2.85–5.94) * Diabetes 1.92 (1.27–2.91) * €Including only variables with P-value <0.2 in UV analysis. * P-value <0.01. Disclosures All authors: No reported disclosures.

Less Is More: Surgical Procedure Time and Risk of Infections, Length-of-Stay, and Readmission across Three Distinct Surgeries