Measuring postoperative complications in general surgery patients using an outcomes-based strategy : Comparison with complications presented at morbidity and mortality rounds. Discussion.
Annual Meeting of the Central Surgical Association. Chicago (USA), 1997/03/07.
This study was undertaken to compare the incidence of adverse postoperative outcomes recorded in a prospective general surgery database with that identified through weekly morbidity and mortality (M & M) rounds and to measure the impact of feedback of information to the providers of care.
Data were collected on patients admitted to one general surgery service between October 1,1995, and May 15,1996, and recorded in a computer database.
Postoperative complications were graded in severity from I (minor) to IV (mortality).
Of 479 admissions entered into the database during the study period, 325 (311 patients) led to operations and were further analyzed.
Admissions resulting in complications were associated with longer hospital stays, regardless of complication grade, compared to uncomplicated admissions (p<0. 01).
A total of 29 of 106 patients with postoperative complications were presented at M & Ms (27.4%). Whereas 15.4% of database patients with grade I complications were presented at M & Ms, this proportion increased to 22.2% for grade IIa, 34.8% for grade IIb, 33.3% for grade III, and 87.5% for grade IV. (p<0.05 for grade I, IIa, and IIb compared to grade IV).
A total of 58 of 142 patients in the first part of the study period developed complications (40.8%), compared to 53 of 183 patients in the second part of the study (29%, p=0.034). (...)
Mots-clés Pascal : Chirurgie, Influence, Enseignement, Complication, Epidémiologie, Morbidité, Mortalité, Optimisation, Soin, Etude statistique, Homme
Mots-clés Pascal anglais : Surgery, Influence, Teaching, Complication, Epidemiology, Morbidity, Mortality, Optimization, Care, Statistical study, Human
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Cote : 97-0543438
Code Inist : 002B25N. Création : 24/03/1998.