Risk Factors for Retained Surgical Items: A Meta-analysis and Proposed Risk Stratification System

Moffatt-Bruce, Susan D.; Cook, Christopher; Steinberg, Steven; Stawicki, S.P.

doi:10.1016/j.jss.2013.11.387

Cited by 8 publications

(15 citation statements)

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“…Two of the 3 largest case-control studies available to date also identified high BMI as a risk factor, 2,20 while in a metaanalysis that involved all 3 studies, no significant association between BMI and RFB was seen. 39 Our finding potentially concurs with both because we identified obesity as a risk factor in abdominopelvic interventions only, but not in the whole sample. The previously mentioned studies 2,20,39 did not provide anatomic stratification to allow further verification of this hypothesis.…”

Section: Discussionsupporting

confidence: 86%

“…2,20,38 However, no significant difference in risk was observed in the previously mentioned meta-analysis. 39 As for the association of consequences with RFB, postoperative complications were twice as likely to be observed in patients with RFB compared with controls. Complications due to retained objects have been described frequently in previous investigations; however, the lack of comparison groups in most of these studies limits the significance of their findings.…”

Section: Discussionmentioning

confidence: 99%

“…These findings were more evident for interventions outside of the abdominopelvic region, and agree with similar results from the previously mentioned meta-analysis, which showed that emergent cases were not associated with a higher risk of RFB. 39 Regardless of the site of intervention; the presence of a major operating room procedure represented a recognizable risk factor.…”

Section: Discussionmentioning

confidence: 99%

“…2,20,38 However, in a recent meta-analysis that included the previously mentioned studies, several factors exhibited significant risk for unintentional RFB, including intraoperative blood loss of more than 500 mL, longer duration of operation, involvement of more than 1 subprocedure or surgical team, unexpected intraoperative factors, and finally, lack of or incorrect surgical count. 39 In this study, we aimed to assess the frequency of RFB at the national level and across all disciplines, as opposed to previous studies that have focused on certain institutions' experiences and specific fields. We also aimed to identify the risk factors for and the clinical and economic outcomes associated with RFB in the United States by using data from the Nationwide Inpatient Sample (NIS) for the period of 2003 to 2009.…”

mentioning

confidence: 99%

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Retained Foreign Bodies: Risk and Outcomes at the National Level

Al‐Qurayshi

Hauch

Slakey

et al. 2015

Journal of the American College of Surgeons

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Retained Foreign Bodies: Risk and Outcomes at the National Level

Al‐Qurayshi

Hauch

Slakey

et al. 2015

Journal of the American College of Surgeons

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“…The AORN guideline recommends that additional measures be performed based on the individual health care organization's own risk analysis 5 . Researchers conducted a meta‐analysis of 19 research studies and found the following risk factors for RSIs: blood loss greater than 500 mL, longer surgeries, surgeries in which more than one procedure was performed, lack of a count, the presence of more than one surgical team, unexpected intraoperative factors, and incorrect counts 6 …”

Section: Literature Reviewmentioning

confidence: 99%

The Hidden Costs of Reconciling Surgical Sponge Counts

Steelman¹,

Schaapveld²,

Perkhounkova³

et al. 2015

AORN Journal

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Retained surgical sponges are serious adverse events that can result in negative patient outcomes. The primary method of prevention is the sponge count. Searching for sponges to reconcile counts can result in inefficient use of OR time. The purpose of this descriptive study was to estimate the cost of nonproductive OR time (ie, time spent not moving forward with the surgical procedure) spent reconciling surgical sponge counts and the cost of using radiography to rule out the presence of retained sponges. We included 13,322 patient surgeries during a nine-month period. Perioperative personnel required from one to 90 minutes of additional time to reconcile each of 212 incorrect/unresolved counts. The total annualized cost of OR time spent searching for sponges and ruling out the presence of potentially retained sponges using radiography was $219,056. These costs should be included in comprehensive cost analyses when considering alternatives to supplement the surgical count.

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A qualitative content analysis of retained surgical items: learning from root cause analysis investigations

Hibbert

Thomas

Deakin

et al. 2020

International Journal for Quality in Health Care

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Objective To describe incidents of retained surgical items, including their characteristics and the circumstances in which they occur. Design A qualitative content analysis of root cause analysis investigation reports. Setting Public health services in Victoria, Australia, 2010–2015. Participants Incidents of retained surgical items as described by 31 root cause analysis investigation reports. Main Outcome Measure(s) The type of retained surgical item, the length of time between the item being retained and detected and qualitative descriptors of the contributing factors and the circumstances in which the retained surgical items occurred. Results Surgical packs, drain tubes and vascular devices comprised 68% (21/31) of the retained surgical items. Nearly one-quarter of the retained surgical items were detected either immediately in the post-operative period or on the day of the procedure (7/31). However, about one-sixth (5/31) were only detected after 6 months, with the longest period being 18 months. Contributing factors included complex or multistage surgery; the use of packs not specific to the purpose of the surgery; and design features of the surgical items. Conclusion Retained drains occurred in the post-operative phase where surgical counts are not applicable and clinician situational awareness may not be as great. Root cause analysis investigation reports can be a valuable means of characterizing infrequently occurring adverse events such as retained surgical items. They may detect incidents that are not detected by other data collections and can inform the design enhancements and development of technologies to reduce the impact of retained surgical items.

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Risk Factors for Retained Surgical Items: A Meta-analysis and Proposed Risk Stratification System

Cited by 8 publications

References 0 publications

Retained Foreign Bodies: Risk and Outcomes at the National Level

Retained Foreign Bodies: Risk and Outcomes at the National Level

The Hidden Costs of Reconciling Surgical Sponge Counts

A qualitative content analysis of retained surgical items: learning from root cause analysis investigations

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