Synergistic use of Unplanned Reoperation and Hospital Readmission rates for quality monitoring in pediatric surgical care.

IF 1.5 3区医学 Q2 PEDIATRICS Pediatric Surgery International Pub Date : 2024-11-16 DOI:10.1007/s00383-024-05894-8

Galindo Margarita, Contreras Catalina, Benavente Ana, Cancino Bélgica, Montedonico Sandra

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Abstract

Introduction: Unplanned reoperation (URO) and unplanned hospital readmission (UHR) are key quality indicators used to assess healthcare quality improvement. The aim of this study was to describe, quantify, analyze and compare both indicators in a Pediatric Surgery Department.

Methodology: An observational study was conducted reviewing the medical records of pediatric patients who underwent unplanned reoperation and unplanned hospital readmission over a six-year period in a pediatric surgical unit. The incidence, indications, and causes of reoperations and readmissions were analyzed.

Results: A total of 6,376 surgeries were performed over a six-year period. During this time, there were 37 (0.58%) URO and 20 (0.31%) UHR. There were 23/2,437(0.94%) URO and 14/2,437(0.57%) UHR among emergency surgeries. In contrast, there were 14/3,939(0.35%) URO and 6/3,939(0.15%) UHR among elective surgeries (p < 0.05). Outpatient surgeries had 3/1,639 (0.18%) URO and 1/1,639 (0.06%) UHR compared to inpatient surgeries that had 11/2,300(0.47%) URO and 5/2,300 (0.21%) UHR respectively (p = ns). A total of 1,570 appendectomies were performed during the study period, with 8/1,570(0.5%) patients requiring either a URO or a UHR. The most frequent indication for both URO and UHR were intra-abdominal infections. The main cause of URO was a technical error during surgery (70%), while the main cause of UHR was an error in the medical treatment (35%).

Conclusion: In our practice, URO are more frequent than UHR. Emergency surgeries have a higher risk of undergoing an URO or a UHR. Acute appendicitis is the most common diagnosis associated with the need for an URO or a UHR. The majority of unplanned reoperation cases are due to technical errors during surgery.

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协同使用非计划再手术率和住院再住院率对儿科外科护理进行质量监控。

导言：非计划再手术（URO）和非计划再入院（UHR）是用于评估医疗质量改进的关键质量指标。本研究旨在描述、量化、分析和比较小儿外科的这两项指标：方法：我们开展了一项观察性研究，查阅了一家儿科手术室六年内接受非计划再手术和非计划再入院治疗的儿科患者的病历。研究分析了再次手术和再次入院的发生率、适应症和原因：结果：六年内共进行了 6,376 例手术。在此期间，有 37 例（0.58%）URO 和 20 例（0.31%）URR。在急诊手术中，URO 为 23 例/2,437 例（0.94%），URR 为 14 例/2,437 例（0.57%）。相比之下，在择期手术中有 14/3,939 例（0.35%）URO，6/3,939 例（0.15%）URR（P 结论：在我们的临床实践中，URO 比URHR 多：在我们的临床实践中，URO 比 UHR 更为常见。急诊手术接受URO或UHR的风险更高。急性阑尾炎是需要进行URO或UHR的最常见诊断。大多数非计划再手术病例都是由于手术过程中的技术错误造成的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor