The effect of postoperative respiratory and mobilization interventions on postoperative complications following abdominal surgery: a systematic review and meta-analysis

Kokotovic, Dunja; Berkfors, Adam A; Gögenür, Ismail; Ekeloef, Sarah; Burcharth, Jakob

doi:10.1007/s00068-020-01522-x

Cited by 20 publications

(7 citation statements)

References 54 publications

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“…This highlights that, in addition to surgical performance, the outcome of treatment is dependent on the trust between a patient and the healthcare system. Communication about adverse events beforehand, patient education [18,19], and proper rehabilitation [20][21][22] improve the quality of surgical care. A patient-reported outcome measurement after surgery should be part of standard data collection in order to further develop the quality of invasive procedures [23].…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…Two systematic reviews were carried out on a population with asthma [ 47 , 49 ], two were carried out on a population with amyotrophic lateral sclerosis [ 19 , 34 ], two were carried out on a population with multiple sclerosis [ 44 , 55 ], two were carried out on a population with Parkinson’s disease [ 11 , 20 ], three were carried out on people who were poststroke [ 12 , 18 , 37 ], one was carried out on a population with pulmonary fibrosis [ 25 ], and three were carried out on a population with lung cancer [ 14 , 26 , 45 ]. Six reviews focused on preoperatory preparation [ 24 ] and postoperatory preparation [ 31 , 33 , 52 , 56 ], and three reviews focused on the respiratory exercises for abdominal surgeries [ 17 , 50 , 57 ]. Four studies pointed out the efficacy of the interventions on patients with cardiac failure [ 23 , 39 , 48 , 58 ], and one pointed the significance of the interventions on patients with a Fontan circulation [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review

Reis¹,

Gaspar

Silva

et al. 2023

IJERPH

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This umbrella review aimed to determine the effectiveness of nonpharmacological interventions in pulmonary ventilation and their impact on respiratory function. An individual with impaired ventilation displays visible variations manifested in their respiratory frequency, breathing rhythm ratio (I:E), thoracic symmetry, use of accessory muscles, dyspnea (feeling short of breath), oxygen saturation, diaphragm mobility, minute ventilation, peak flow, walking test, spirometry, Pimax/Pemax, diffusion, and respiratory muscle strength. Any variation in these markers demands the need for interventions in order to duly manage the signs and symptoms and to improve ventilation. Method: Systematic reviews of the literature published in English, Spanish, French, and Portuguese were used, which included studies in which nonpharmacological interventions were used as a response to impaired ventilation in adults in any given context of the clinical practice. The recommendations given by the Joanna Briggs Institute (JBI) for umbrella reviews were followed. This research took place in several databases such as MEDLINE, CINAHL Complete, CINHAL, MedicLatina, ERIC, Cochrane Reviews (Embase), and PubMed. The Joanna Briggs critical analysis verification list was used for the systematic review. The data extraction was performed independently by two investigators based on the data extraction tools of the Joanna Briggs Institute, and the data were presented in a summary table alongside the support text. Results: Forty-four systematic reviews, thirty randomized clinical essays, and fourteen observational studies were included in this review. The number of participants varied between n = 103 and n = 13,370. Fifteen systematic revisions evaluated the effect of isolated respiratory muscular training; six systematic revisions evaluated, in isolation, breathing control (relaxed breathing, pursed-lip breathing, and diaphragmatic breathing exercises) and thoracic expansion exercises; and one systematic review evaluated, in isolation, the positions that optimize ventilation. Nineteen systematic reviews with combined interventions that reinforced the role of education and capacitation while also aiming for their success were considered. The articles analyzed isolated interventions and presented their efficacy. The interventions based on respiratory exercises and respiratory muscular training were the most common, and one article mentioned the efficacy of positioning in the compromisation of ventilation. Combined interventions in which the educational component was included were found to be effective in improving pulmonary function, diffusion, oxygenation, and functional capacity. The outcomes used in each study were variable, leading to a more difficult analysis of the data. Conclusions: The interventions that were the focus of the review were duly mapped. The results suggest that nonpharmacological interventions used to optimize ventilation are effective, with a moderate to high level of evidence. There is a strong foundation for the use of the chosen interventions. The lack of studies on the intervention of “positioning to optimize ventilation” points out the need for a deeper analysis of its effects and for studies with a clear focus. This study supports the decisions and recommendations for the prescription of these interventions to patients with impaired ventilation.

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“…In terms of study cohorts, current information on risk factors is based almost exclusively on data from older adults [ 7 ], whereas our study limited the age of the patient cohort to 18-44 years, which to some extent fills the gap in existing research data. A study has shown that the proportion of short-term postoperative complications did not differ significantly between the older patients and younger patients ( P = 0.097) [ 13 ]; however, due to the different bodily functions of elderly patients and young patients, the development of the long-term physical condition in the two types of patients will be different. Both overall survival and disease-specific survival (DSS) rates declined with advancing age; this may be due to elderly patients' poor physical recovery and their chronic disease [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Prediction of Postoperative Survival in Young Colorectal Cancer Patients: A Cohort Study Based on the SEER Database

Pan

Mei

Huang

et al. 2022

Journal of Immunology Research

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Objective. Our aim is to make accurate and robust predictions of the risk of postoperative death in young colorectal cancer patients (18-44 years old) by combining tumor characteristics with medical and demographic information about the patient. Materials and Methods. We used the SEER database to retrieve young patients diagnosed with colorectal cancer who had undergone surgery between 2010 and 2015 as the study cohort. After excluding cases with missing information, the study cohort was divided in a 7 : 3 ratio into a training dataset and a validation dataset. To assess the predictive ability of each predictor on the prognosis of colorectal cancer patients, we used two steps of Cox univariate analysis and Cox stepwise regression to screen variables, and the screened variables were included in a multifactorial Cox proportional risk regression model for modeling. The performance of the model was tested using calibration curves, decision curves, and area under the curve (AUC) for receiver operating characteristic (ROC). Results. After excluding cases with missing information ( n = 23,606 ), a total of 11,803 patients were included in the study with a median follow-up time of 45 months (1-119). In the training set, we determined that ethnicity, marital status, insurance status, median annual household income, degree of tumor differentiation, type of pathology, degree of infiltration, and tumor location had independent effects on prognosis. In the training dataset, taking 1 year, 3 years, and 5 years as the time nodes, the areas under the working characteristic curve of subjects are 0.825, 0.851, and 0.839, respectively, and in the validation dataset, they are 0.834, 0.837, and 0.829, respectively. Conclusion. We trained and validated a model using a large multicenter cohort of young colorectal cancer patients with stable and excellent performance in both training and validation datasets.

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The effect of postoperative respiratory and mobilization interventions on postoperative complications following abdominal surgery: a systematic review and meta-analysis

Cited by 20 publications

References 54 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

Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review

Prediction of Postoperative Survival in Young Colorectal Cancer Patients: A Cohort Study Based on the SEER Database

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