Document Detail


The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery.
MedLine Citation:
PMID:  10439777     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Vital healthcare resources are devoted to caring for patients with prolonged hospitalization after routine, moderate-risk surgery. Despite the significant cost, little is known about the overall incidence and pattern of complications in these patients. Four hundred thirty-eight patients undergoing a diverse group of routine, moderate-risk, elective surgical procedures were enrolled into a prospective, blinded, cohort study. Complications were assessed using a postoperative morbidity survey. The main outcome was postoperative complication, defined as either in-hospital death or prolonged postoperative hospitalization (> 7 days). The mortality rate was 1.6%. Postoperative complications occurred in 118 patients (27% [95% CI 23-31]). Complications frequently observed in these patients included: gastrointestinal 51% (42-60), pulmonary 25% (17-33), renal 21% (14-28), and infectious 13% (7-19). Most complications were not directly related to the type/site of surgery. Indices of tissue trauma (blood loss [P < 0.001], surgical duration [P = 0.001]) and tissue perfusion (arterial base deficit [P = 0.008], gastric pHi [P = 0.02]) were the strongest intraoperative predictors of complications. Despite a low mortality rate, we found that complications after routine, moderate-risk, elective surgery are common and involve multiple organ systems. Our 9-point survey can be used by healthcare providers and payers to characterize post-operative morbidity in their respective settings. Implications: Little is known about the overall incidence and pattern of complications in patients with prolonged hospitalization after routine, elective surgery. We prospectively assessed these complications using a novel postoperative morbidity survey. The postoperative morbidity survey can be used in future clinical outcome trials, as well as in routine hospital-based quality assurance.
Authors:
E Bennett-Guerrero; I Welsby; T J Dunn; L R Young; T A Wahl; T L Diers; B G Phillips-Bute; M F Newman; M G Mythen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  89     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-08-24     Completed Date:  1999-08-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  514-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Mount Sinai Medical Center, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Data Collection
Female
Humans
Length of Stay*
Male
Middle Aged
Odds Ratio
Postoperative Complications / epidemiology*
Prospective Studies
Risk Factors
Surgical Procedures, Elective*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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