Can the Incidence of Unplanned Reoperations Be Used as an Indicator of Quality of Care in Surgery?

Abstract

The incidence of unplanned reoperations could potentially be used as an indicator of quality of care. This study provided insight into the incidence of unplanned reoperations in a surgical department and added to the discussion of the value of unplanned reoperations as an indicator of quality of care. Between January 1996 and December 2003, all unplanned reoperations were entered prospectively into a complication registration system. The number of unplanned reoperations was 447 (1.7%). Unplanned reoperations occurred frequently after vascular (6.5%) and colon surgery (5.7%) and were caused predominantly by errors in surgical technique (70%) and patients' comorbidities (21%). Mortality for patients requiring unplanned reoperations was significantly higher than for patients who did not require reoperations (10.3% versus 4.0%). Unplanned reoperation rates can be an indicator of quality of care. However, a prospective, well-defined registry is essential to ensure an accurate assessment of the quality of care provided.

Morbidité et mortalité d'origine cardiaque après revascularisation pour ischémie critique

“…Elle pourrait ê tre utilis ee comme crit ere de qualit e dans les domaines de la chirurgie et des soins en g en eral. 22 Figure 1, les EIs sont li es a leurs cons equences a court terme. Les EIs mineurs menaient de mani ere egale a l'absence de cons equence ou a l'administration de transfusions/m edicaments suppl ementaires (56%) et a une r eintervention (44%) pour h emorragie postop eratoire (n ¼ 2) ou reprise de cicatrice (n ¼ 2).…”

Patient and procedure-related risk factors for adverse events after infrainguinal bypass

“…Determinants erations are associated with more AEs compared with elective cases,6,21,42,43 as well as a possible difference in AE occurrence between open and endovascular procedures as a the primary choice of treatment. These factors, which were not measured in this study, might explain part of the lower AE occurrence in health care facility 2, if this facility were, for instance, to treat more patients undergoing primary revascularization instead of redo procedures or were to have a different mix in open and endovascular procedures.…”

“…[3][4][5] Therefore, AEs can be used as outcome measures to assess the quality of surgical care. [6][7][8] Owing to extensive comorbid conditions and technically challenging surgical revascularization procedures, patients treated for peripheral arterial occlusive disease (PAOD) are at high risk for developing AEs. Rutherford et al 9,10 proposed an AE registration classification.…”

“…8,11,12 The Association of Surgeons of the Netherlands (ASN) 13 developed a uniform definition of an AE. Three teaching hospitals in the Netherlands-the Department of Vascular Surgery of the St. Elisabeth Hospital in Tilburg (EH), 3,8,14 the Red Cross (RCH) and the Leyweg locations in The Hague of the Haga Hospital, [4][5][6][15][16][17][18][19][20][21][22][23][24] and the Leiden University Medical Centre (LUMC) 13,[25][26][27] -used this definition and have been documenting AEs prospectively according to this definition for Ͼ15 years.…”

A nationwide analysis of re-operation after kidney transplant

“…[1][2][3] Comorbid conditions, surgical errors, and perioperative factors are all known to be associated with unplanned reoperation. 2 Although there is some understanding of these issues, further investigation of the causes driving unplanned reoperation can improve surgical techniques and surgical outcomes. Kidney transplantion is an established procedure with a high worldwide success rate.…”