Complications Within 30 Days of Hand Surgery: An Analysis of 10,646 Patients

Lipira, Angelo B.; Sood, Ravi F.; Tatman, Philip D.; Davis, Jeffrey Isaac; Morrison, Shane D.; Ko, Jason H.

doi:10.1016/j.jhsa.2015.06.103

Cited by 83 publications

(78 citation statements)

References 26 publications

(18 reference statements)

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“…Timing was significantly earlier in inpatients compared with outpatients for myocardial infarction (day 1 [IQR: [1][2][3] vs. day 3 [IQR: [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], p = 0.006) (►Table 3 and ►Fig. 3).…”

Section: Resultsmentioning

confidence: 99%

“…15 Hand, wrist, and forearm procedures performed between 2005 and 2016 were identified based on the 208 Current Procedural Technology codes that have previously been determined as representative of hand, wrist, and forearm surgery in the NSQIP database. 6 This study was granted an exemption by our institutional review board as all data are de-identified.…”

Section: Methodsmentioning

confidence: 99%

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Timing of Complications following Hand Surgery

Goyal

Bohl

Wysocki

2022

Journal of Hand and Microsurgery

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Introduction Our purposes were to (1) characterize the timeline of eight postoperative complications following hand surgery, (2) assess complication timing for the procedures that account for the majority of adverse events, and (3) determine any differences in complication timing between outpatient and inpatient procedures. Materials and Methods Patients undergoing hand, wrist, and forearm procedures from 2005 to 2016 were identified in the National Surgical Quality Improvement Program database. Timing of eight adverse events was characterized. Cox proportional hazards modeling was used to compare adverse event timing between inpatient and outpatient procedures. Results A total of 59,040 patients were included. The median postoperative day of diagnosis for each adverse event was as follows: myocardial infarction 1, pulmonary embolism 2, acute kidney injury 3, pneumonia 8, deep vein thrombosis 9, sepsis 13, urinary tract infection 15, and surgical site infection 16. Amputations, fasciotomies, and distal radius open reduction internal fixation accounted for the majority of adverse events. Complication timing was significantly earlier in inpatients compared with outpatients for myocardial infarction. Conclusion This study characterizes postoperative adverse event timing following hand surgery. Surgeons should have the lowest threshold for testing for each complication during the time period of greatest risk. Level of Evidence This is a therapeutic, Level III study.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Timing of Complications following Hand Surgery

Goyal

Bohl

Wysocki

2022

Journal of Hand and Microsurgery

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“…Trauma surgery and orthopaedics have been reported the discipline most frequently confronted with claims of medical malpractice [15]. In a large study [5] including 10,646 patients, the overall incidence of complications within 30 days after hand surgery was only 2.5%. Older age, diabetes, chronic obstructive pulmonary disease, congestive heart failure, atherosclerosis, steroids, bleeding disorder, increasing wound class, emergency procedure, longer operative time and preoperative transfusion were associated with significantly higher risk of complications.…”

Section: Discussionmentioning

confidence: 99%

“…Postoperative infection has been one of the complications in hand surgery [5]. The incidence of postoperative infections has been reported between 0.5% and 6.0%, depending on centre, type of surgery, and site of surgery [5,18,19].…”

Section: Discussionmentioning

confidence: 99%

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Wrist malpractice claims in Northern Norway 2005–2014. Lessons to be learned

Norum

Balteskard

Thomsen³

et al. 2018

International Journal of Circumpolar Health

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Rough weather conditions in the subarctic areas of Norway may influence on the risk of wrist fracture. We implemented data from the Norwegian System of Patient Injury Compensation (NPE). All claims due to wrist surgery, performed at the public hospitals in Northern Norway, during 2005-2014 were analyzed. We employed the ICD-10 classification codes S52.5 (fracture of distal end of radius) and S52.6 (fracture of distal end of radius and ulna). Treatment was defined by NCSP codes. 84 patients (0.3%) complained. Females complained four times more often than males did (P = 0.005) and received five times more frequently a compensation (P < 0.001). NPE accepted 34 claims (40%) for injury compensation (0.1% of patients). The percentage of claims accepted for compensation decreased from 48% to 30% during study period, probably due to delay in filling claims. The main causes of complains were pain, reduced range of motion, malfunction and weakness (35/84). The main causes of compensation were “operative treatment should have been performed” (14/34) and “wrong operative method applied” (13/34). The mean amount per compensation was €14,927 (€0–€52,995). Stonger focus on quality of care, updated guidelines and shared decission-making may reduce the number og complains and compensations.

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Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

Hoftiezer

Lans

Freniere

et al. 2020

Journal of Surgical Oncology

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Background and ObjectivesThe incidence of soft tissue complications following sarcoma surgery in the upper extremity is reportedly high. Therefore, this study assessed the National Surgical Quality Improvement Program (NSQIP) database to identify independent risk factors, while also reporting the incidence of soft tissue complications in the first 30 days after surgery.MethodsA total of 620 patients that underwent surgical treatment for upper extremity sarcoma were included from the NSQIP database. Soft tissue complications were defined as surgical site infection, wound dehiscence, or soft‐tissue related reoperations. Clinically relevant patient and treatment characteristics were selected and analyzed.ResultsThe 30‐day soft tissue complication rate was 4.7%. In the multivariable analysis, higher body mass index (p = .047) and longer operative times (p = .002) were independently associated with soft tissue complications.ConclusionsHigher body mass index and longer operative times are risk factors for soft tissue complications following upper extremity sarcoma surgery. The soft‐tissue complication rate following resection of upper extremity tumors is low in this national cohort, possibly due to the relatively small tumor size and low prevalence of radiotherapy.

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Complications Within 30 Days of Hand Surgery: An Analysis of 10,646 Patients

Cited by 83 publications

References 26 publications

Timing of Complications following Hand Surgery

Timing of Complications following Hand Surgery

Wrist malpractice claims in Northern Norway 2005–2014. Lessons to be learned

Factors associated with 30‐day soft tissue complications following upper extremity sarcoma surgery

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