دورية أكاديمية
Complications and Failure to Rescue After Inpatient Pediatric Surgery.
| العنوان: | Complications and Failure to Rescue After Inpatient Pediatric Surgery. |
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| المؤلفون: | Portuondo JI; Center for Innovations in Quality, Effectiveness, and Safety, Michael E DeBakey VA Medical Center, Houston, Texas.; Michael E DeBakey Department of Surgery at Baylor College of Medicine, Houston, Texas., Shah SR; Michael E DeBakey Department of Surgery at Baylor College of Medicine, Houston, Texas.; Texas Children's Hospital Department of Surgery, Surgical Research Unit, Houston, Texas., Raval MV; Surgical Outcomes and Quality Improvement Center, Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.; Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois., Pan IE; Texas Children's Hospital Department of Surgery, Surgical Research Unit, Houston, Texas.; The University of Texas MDAnderson Cancer Center, Department of Health Services Research, Division of Cancer Prevention and Population Sciences, Houston, Texas., Zhu H; Texas Children's Hospital Department of Surgery, Surgical Research Unit, Houston, Texas., Fallon SC; Michael E DeBakey Department of Surgery at Baylor College of Medicine, Houston, Texas.; Texas Children's Hospital Department of Surgery, Surgical Research Unit, Houston, Texas., Harris AHS; Veterans Affairs Health Services Research and Development Center for Innovation to Implementation, Palo Alto Veterans Affairs Health Care System, Menlo Park, California.; Department of Surgery, Stanford University, Palo Alto, California., Singh H; Center for Innovations in Quality, Effectiveness, and Safety, Michael E DeBakey VA Medical Center, Houston, Texas.; Department of Medicine at Baylor College of Medicine, Houston, Texas., Massarweh NN; Center for Innovations in Quality, Effectiveness, and Safety, Michael E DeBakey VA Medical Center, Houston, Texas.; Michael E DeBakey Department of Surgery at Baylor College of Medicine, Houston, Texas.; Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Texas. |
| المصدر: | Annals of surgery [Ann Surg] 2022 Oct 01; Vol. 276 (4), pp. e239-e246. Date of Electronic Publication: 2020 Oct 19. |
| نوع المنشور: | Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins |
| مواضيع طبية MeSH: | Failure to Rescue, Health Care*, Adult ; Child ; Cohort Studies ; Hospital Mortality ; Humans ; Inpatients ; Postoperative Complications/epidemiology ; Retrospective Studies |
| مستخلص: | Objective: To describe the frequency and patterns of postoperative complications and FTR after inpatient pediatric surgical procedures and to evaluate the association between number of complications and FTR. Summary and Background: FTR, or a postoperative death after a complication, is currently a nationally endorsed quality measure for adults. Although it is a contributing factor to variation in mortality, relatively little is known about FTR after pediatric surgery. Methods: Cohort study of 200,554 patients within the National Surgical Quality Improvement Program-Pediatric database (2012-2016) who underwent a high (≥ 1%) or low (< 1%) mortality risk inpatient surgical procedures. Patients were stratified based on number of postoperative complications (0, 1, 2, or ≥3) and further categorized as having undergone either a low- or high-risk procedure. The association between the number of postoperative complications and FTR was evaluated with multivariable logistic regression. Results: Among patients who underwent a low- (89.4%) or high-risk (10.6%) procedures, 14.0% and 12.5% had at least 1 postoperative complication, respectively. FTR rates after low- and high-risk procedures demonstrated step-wise increases as the number of complications accrued (eg, low-risk- 9.2% in patients with ≥3 complications; high-risk-36.9% in patients with ≥ 3 complications). Relative to patients who had no complications, there was a dose-response relationship between mortality and the number of complications after low-risk [1 complication - odds ratio (OR) 3.34 (95% CI 2.62-4.27); 2 - OR 10.15 (95% CI 7.40-13.92); ≥3-27.48 (95% CI 19.06-39.62)] and high-risk operations [1 - OR 3.29 (2.61-4.16); 2-7.24 (5.14-10.19); ≥3-20.73 (12.62-34.04)]. Conclusions: There is a dose-response relationship between the number of postoperative complications after inpatient surgery and FTR, ever after common, "minor" surgical procedures. These findings suggest FTR may be a potential quality measure for pediatric surgical care. Competing Interests: The authors report no conflicts of interest. (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.) |
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| تواريخ الأحداث: | Date Created: 20201021 Date Completed: 20220913 Latest Revision: 20230131 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1097/SLA.0000000000004463 |
| PMID: | 33086325 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1528-1140 |
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| DOI: | 10.1097/SLA.0000000000004463 |