Patient injuries in operative rhinology during a ten‐year period: Review of national patient insurance charts

Blomgren, Karin; Aaltonen, Leena‐Maija; Lehtonen, Lasse; Helmiö, Päivi

doi:10.1111/coa.12894

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…In order to use claims for this purpose, the number of claims needs to be adjusted by the volume of treatment provided. In Finland, this has been done earlier for some specialties or procedures [9][10][11][12][13]. Previous studies suggest that claims and compensation rates vary considerably, but the rates across all surgical procedures are unknown.…”

Section: Introductionmentioning

confidence: 99%

Patterns of malpractice claims and compensation after surgical procedures: a retrospective analysis of 8,901 claims from the Finnish patient insurance registry

Welling¹,

Takala

2023

Patient Saf Surg

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Background Invasive surgical procedures carry risk of harm to patients. In addition to avoidable harm, disparities between patient expectations and the outcome of a procedure may lead to patient injury claims. The follow-up of claims and compensation is an important entity for patient safety. The number of claims should be related to the surgical volume, so that a healthcare provider can benchmark with similar organizations and see if its trends are developing favourably or deteriorating. Our objective was to find out the claims and compensation rates due to surgery in an insurance-based system. Methods Data related to surgical claims and reference volume in the period 2011–2015 were collected from the claim register of the Finnish Patient Insurance Centre and benchmarking community register of Finnish operating departments. The data included age, gender, hospital, year of surgery, surgical code, and outcome of the claim. Results There were 8,901 claims related to the corresponding reference group of 1,470,435 surgical procedures. The claims rate was 0.61% and compensation rate was 0.22%. Trends for claims and compensation rates decreased over the study period. In high volume procedures, a low compensation rate was detected for excision of tonsils and adenoids, Caesarean section and extracapsular cataract operations using the phacoemulsification technique. A high compensation rate was detected for primary prosthetic replacement of the hip and knee joints and decompression of spinal cord and nerve roots. Unreasonable injury (death or permanent deterioration of health) was compensated in 2.4 per 100,000 procedures. Conclusions Register data research in a no-fault patient insurance system revealed a claims rate of 6 per 1,000 procedures and compensation rate of 2 per 1,000 procedures. A decreasing trend in both rates over the study period was detected. Different surgical procedures exhibit varying claims and compensation rates.

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Section: Introductionmentioning

confidence: 99%

Patterns of malpractice claims and compensation after surgical procedures: a retrospective analysis of 8,901 claims from the Finnish patient insurance registry

Welling¹,

Takala

2023

Patient Saf Surg

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“…The categories of 'manual and judgment errors in surgery' were added to the classification [12,13]. The classification used in this study was developed by the research group and has been used in three previous publications [8,10,14]. Incidents and errors contributing to the injury were identified and classified by two senior otolaryngologists (KB and PH).…”

Section: Definition Of Key Variablesmentioning

confidence: 99%

Patient injuries in pediatric otorhinolaryngology

Nokso-Koivisto

Blomgren

Aaltonen

et al. 2019

International Journal of Pediatric Otorhinolaryngology

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“…Reducing the amount of operative field blood loss can not only improve the identification of local anatomical structures, but also help to avoid rare and potentially catastrophic complications. 2 General anesthesia has gradually replaced classic local anesthesia and has become the mainstream anesthesia technique for ESS in view of its fixed surgical field and convenient airway management. 3 Controlled hypotension (CH), which maintains a target mean arterial blood pressure (MAP) of between 55 and 65 mmHg, is important to improve VSF when performing ESS under general anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Hypotensive Levels on Endoscopic Sinus Surgery Visibility: A Randomized Non‐Inferiority Trial

Zhang

Wang

et al. 2023

The Laryngoscope

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ObjectiveOptimization of endoscopic sinus surgery (ESS) conditions is a common focus of interest for otolaryngologists and anesthesiologists. Relying on hypotension alone to achieve a bloodless field may not without risks. We sought to determine whether ESS is feasible in the context of moderate hypotension.MethodsThis randomized non‐inferiority trial enrolled 96 adult patients who were to undergo ESS. The patients were divided into two groups: Controlled hypotension group (n = 48, MAP reduction to 55–65 mmHg, minimum of 60% of baseline blood pressure) or Individualized hypotension group (n = 48, MAP reduction to 75–80% of baseline blood pressure). All participants were placed in 10° reverse Trendelenburg position during ESS, and cottonoid patties dammed with epinephrine was recommended to clear the operative field of bleeding. The two groups were compared according to Boezaart grading scale (BS) score, estimated blood loss, blood loss rate, arterial lactate level and postoperative recovery.ResultsBoth levels of intraoperative hypotension (62.2 ± 2.3 mmHg vs. 74.0 ± 2.8 mmHg) provided acceptable surgical conditions with no difference in mean BS scores [2.00 (1.88–2.33) vs. 2.00 (1.85–2.45), p = 0.926]. The 95% CI for median value differences in mean BS scores is lower than the preset non‐inferiority margin. There were no differences in blood loss rate and estimated blood loss between two groups (p > 0.05) Postoperative arterial lactate and Ramsay sedation scores were significantly different between the two groups (p < 0.05).ConclusionsIn ESS, both levels of intraoperative hypotension, combined with position adjustment and low‐concentration adrenaline to constrict nasal mucosal blood vessels, provided acceptable surgical conditions.Level of Evidence2 Laryngoscope, 2023

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Patient injuries in operative rhinology during a ten‐year period: Review of national patient insurance charts

Abstract: Objectives: To assess factors contributing to patient injuries in operative rhinology.

Cited by 9 publications

References 21 publications

Patterns of malpractice claims and compensation after surgical procedures: a retrospective analysis of 8,901 claims from the Finnish patient insurance registry

Patterns of malpractice claims and compensation after surgical procedures: a retrospective analysis of 8,901 claims from the Finnish patient insurance registry

Patient injuries in pediatric otorhinolaryngology

Hypotensive Levels on Endoscopic Sinus Surgery Visibility: A Randomized Non‐Inferiority Trial

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