| The use of a postoperative morbidity survey to evaluate patients with prolonged hospitalization after routine, moderate-risk, elective surgery. | |
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MedLine Citation:
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PMID: 10439777 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 89 ISSN: 0003-2999 ISO Abbreviation: Anesth. Analg. Publication Date: 1999 Aug |
Date Detail:
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Created Date: 1999-08-24 Completed Date: 1999-08-24 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 514-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology, Mount Sinai Medical Center, New York, New York, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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