In- and out-hospital mortality rate in surgical patients

Dony, Philippe; Pirson, Michael; Boogaerts, Jean G.

doi:10.1080/00015458.2017.1353236

Cited by 7 publications

(8 citation statements)

References 25 publications

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“…A 2018 study that evaluated in-and out-of-hospital deaths involving adult patients who were admitted for elective and nonelective inpatient surgery reported that out-of-hospital deaths after inpatient surgery accounted for 18% of 30-day mortality. 15 Other studies have shown how the proportions of out-of-hospital deaths were dependent on the type of surgery, with out-of-hospital deaths ranging from 8% (bladder) to 50% (breast) after cancer surgeries, 16 and 53% after hip fracture surgeries. 5 We found lower proportions of out-of-hospital deaths compared with the literature.…”

Section: Discussionmentioning

confidence: 98%

Use of linked data to assess the impact of including out-of-hospital deaths on 30-day in-hospital mortality indicators: a retrospective cohort study

Syrowatka

et al. 2022

cmajo

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T he Canadian Institute for Health Information (CIHI) supports national data collection, analysis and reporting to accelerate improvements in health system performance across Canada. 1 As part of this work, CIHI annually reports on health system performance indicators, including various 30-day in-hospital mortality rates. 2,3 The accuracy of 30-day mortality rates is dependent on the completeness and quality of the available data. The 30-day mortality rates measure in-hospital deaths documented in administrative health databases, such as the Discharge Abstract Database (DAD), based on the availability of timely data. 4 This approach has been shown to underestimate overall 30-day mortality rates in other countries, as it does not include deaths that occur outside of the hospital. [5][6][7][8] To report more comprehensive measures, administrative health data have been linked with national death registries to capture out-of-hospital deaths. 9 In Canada, inclusion of both in-and out-of-hospital deaths may provide a more comprehensive and patient-centred assessment of health system performance, which is becoming increasingly important as hospital lengths of stay are becoming shorter as care shifts from inpatient to other settings. We aimed to assess the impact of including out-of-hospital deaths on 3 of CIHI's key mortality indicators: 30-day acute myocardial infarction (AMI) in-hospital mortality, 30-day stroke in-hospital mortality and hospital deaths following major surgery.

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Section: Discussionmentioning

confidence: 98%

Use of linked data to assess the impact of including out-of-hospital deaths on 30-day in-hospital mortality indicators: a retrospective cohort study

Syrowatka

et al. 2022

cmajo

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“…This number of postoperative deaths accounts for 7.7% of all deaths globally, making it the third greatest contributor to deaths in the world [ 1 ]. In a study of the University Hospital of Charleroi in Belgium, post-operative mortality rates within 30 post-operative days were 1.1% [ 2 ]. In this hospital, risk factors of post-operative mortality were identified as the absence of an anesthesia nurse, American Society of Anesthesiologists scores (ASA scores) > 2, emergency, duration of surgery and rate of admission to critical care unit [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of collaborative physician-pharmacist stewardship strategies on prophylactic antibiotic practices: a quasi-experimental study

Pardo

Ntabaza

Rivolta

et al. 2022

Antimicrob Resist Infect Control

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Background An effective use of surgical antibiotic prophylaxis (SAP) appears essential to prevent the development of infections linked to surgery while inappropriate and excessive prescriptions of prophylactic antibiotics increase the risk of adverse effects, bacterial resistance and Clostridium difficile infections. In this study, we aimed to analyze SAP practices in an acute secondary hospital in Belgium during the years 2016–2021 in order to evaluate the impacts of combined stewardship interventions, implemented thanks to a physician-pharmacist collaboration. Methods A quasi-experimental study on SAP practices was conducted during 5 years (2016–2021) in a Belgian University Hospital. We first performed a retrospective observational transversal study on a baseline group (2016.1–2016.4). Then, we constituted a group of patients (2017.1–2017.4) to test a combined intervention strategy of stewardship which integrated the central role of a pharmacist in antibiotic stewardship team and in the pre-operative delivery of nominative kits of antibiotics adapted to patient factors. After this test, we collected patient data (2018.1–2018.4) to evaluate the sustained effects of stewardship interventions. Furthermore, we evaluated SAP practices (2019.1–2019.4) after the diffusion of a computerized decision support system. Finally, we analyzed SAP practices in the context of the COVID-19 pandemic (2020.1–2020.4 and 2021.1–2021.4). The groups were compared from year to year in terms of compliance to institutional guidelines, as evaluated from seven criteria (χ2 test). Results In total, 760 surgical interventions were recorded. The observational study within the baseline group showed that true penicillin allergy, certain types of surgery and certain practitioners were associated with non-compliance (p < 0.05). Compared with the baseline group, the compliance was significantly increased in the test group for all seven criteria assessed (p < 0.05). However, the effects were not fully sustained after discontinuation of the active interventions. Following the diffusion of the computerized decision support system, the compliance to guidelines was not significantly improved. Finally, the COVID-19 pandemic did not appear to affect the practices in terms of compliance to guidelines. Conclusions This study shows that optimization of SAP practices is achievable within a proactive multidisciplinary approach including real-time pharmaceutical interventions in the operating area and in the care units practicing SAP.

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“…1,2 Nearly half of all adverse events (AEs) in hospitalized patients are related to surgical care and at least half of the cases in which surgery led to harm are considered preventable. 3 There has been an increasing focus on and advancement in improving the safety culture in the operating room (OR) in order to prevent AEs. The OR may be particularly vulnerable to sentinel events which can result in death, permanent or severe temporary harm.…”

Section: Introductionmentioning

confidence: 99%

The nature of reported safety events related to care coordination in the operating room setting in a tertiary academic center

Krishnan

Wheeler

Pimentel

et al. 2021

J of Healthc Risk Manag

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Adverse event reporting systems are important tools for identifying areas of risk and opportunities for education and improvement. Our goal was to examine the nature of perioperative incident reports related to care coordination that were filed by staff at an academic tertiary care center. In this retrospective data review, perioperative safety reports between 2015 and 2020 were analyzed. Information examined included the type of staff who initiated the report, location of the incident, type of incident and the severity level of event, including patient harm. Out of the 7827 reports evaluated, 61.2% of reports were filed by nurses, and 5.6% by physicians. We investigated one particular category called "coordination of care" and found the specific event most commonly reported was insufficient handoff (15.0%-26.9%), with severity level reported primarily being no to minor harm reaching the patient. However, communication failures were judged to be one of leading causes of inadvertent harm. It is imperative for hospital incident reporting systems to collect data on issues related to communication failures and to design interventions with the help of frontline staff to provide high quality, safe care to patients and to remain compliant with regulatory requirements and hospital policies.

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In- and out-hospital mortality rate in surgical patients

Cited by 7 publications

References 25 publications

Use of linked data to assess the impact of including out-of-hospital deaths on 30-day in-hospital mortality indicators: a retrospective cohort study

Use of linked data to assess the impact of including out-of-hospital deaths on 30-day in-hospital mortality indicators: a retrospective cohort study

Impact of collaborative physician-pharmacist stewardship strategies on prophylactic antibiotic practices: a quasi-experimental study

The nature of reported safety events related to care coordination in the operating room setting in a tertiary academic center

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