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Detection and potential consequences of intraoperative adverse events: A pilot study in the veterans health administration
- Source :
- The American Journal of Surgery. 214:786-791
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Surgical quality improvement efforts have focused on tracking and reducing postoperative mortality and morbidity. However, the prevalence of intraoperative adverse events (IAEs) and their association with postoperative surgical outcomes has been poorly studied. In this study, we detected IAEs using both retrospective chart review and prospective provider reporting. We then examined the association of IAEs with postoperative outcomes. The overall IAE detection rate per case was 0.7 and 0.07 (P 0.0001) based on chart review and provider reporting, respectively. Types of IAEs varied between detection methods. Provider-reported IAEs were more serious, i.e., had a stronger association with 30-day postoperative complications than chart-identified IAEs (risk-adjusted odds ratios were 1.52 vs 1.02, respectively, both p 0.0001). Our findings suggest that IAEs can be detected using either retrospective chart review or prospective provider reporting. However, provider reporting appears more likely to detect serious (albeit infrequent) IAEs compared to chart review.
- Subjects :
- medicine.medical_specialty
Pilot Projects
030230 surgery
03 medical and health sciences
0302 clinical medicine
Chart review
Humans
Medicine
Prospective Studies
Intraoperative Complications
Adverse effect
Retrospective Studies
business.industry
General Medicine
medicine.disease
Veterans health
Quality Improvement
United States
Acs nsqip
United States Department of Veterans Affairs
Postoperative mortality
Surgical Procedures, Operative
030220 oncology & carcinogenesis
Emergency medicine
Surgery
Medical emergency
Detection rate
business
Subjects
Details
- ISSN :
- 00029610
- Volume :
- 214
- Database :
- OpenAIRE
- Journal :
- The American Journal of Surgery
- Accession number :
- edsair.doi.dedup.....1cc0d9a1faf6ad2a272abfdd54d8ab19