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Is unplanned return to the operating room a useful quality indicator in general surgery?
J D Birkmeyer1, L S Hamby, C M Birkmeyer
1VA Outcomes Group (111B), Department of Veterans Affairs Medical Center, White River Junction, VT 05009, USA. john.d.birkmeyer@dartmouth.edu
Archives of Surgery (Chicago, Ill. : 1960)
|May 5, 2001
Summary
Unplanned returns to the operating room (OR) occurred in 3.5% of general surgery patients, often due to complications. Reoperation rates can indicate quality and identify areas for improvement in surgical care.
Area of Science:
- Surgery
- Quality Improvement
- Healthcare Analytics
Background:
- Unplanned returns to the operating room (OR) are a significant concern in general surgery.
- Identifying the frequency and reasons for these returns is crucial for assessing surgical quality.
Purpose of the Study:
- To evaluate unplanned return to the operating room (OR) as a quality indicator in general surgery.
- To determine the incidence and causes of unplanned reoperations in a broad surgical practice.
Main Methods:
- Prospective cohort study involving 3044 patients undergoing general surgery.
- Data collected on postoperative adverse events within 30 days or before discharge.
- Unplanned return to the OR defined as a secondary procedure for index operation complications.
Main Results:
- Overall, 3.5% of patients had an unplanned return to the OR.
- Colon resection, renal transplant, gastric bypass, and pancreatic resection accounted for a disproportionate number of reoperations.
- Reoperations were associated with significantly higher hospital charges and mortality rates for specific procedures.
Conclusions:
- Unplanned returns to the OR are common across various general surgical procedures.
- Reoperation rates serve as a valuable metric for monitoring surgical quality and identifying areas for local improvement.