Background: Unplanned return to the operating room (uROR) has been suggested as a hospital quality indicator. The purpose of this study was to determine reasons for uROR to identify opportunities for patient care improvement.
Methods: uROR reported by our institution's American College of Surgeons National Surgical Quality Improvement Program underwent secondary review.
Results: The uROR rate reported by clinical reviewers was 4.3%. Secondary review re-categorized 64.7% as "true uROR" with the most common reasons for uROR being infection (30.9%) and bleeding (23.6%). Remaining cases were categorized as "false uROR" with the most common reasons being inadequate documentation (60.0%) and not directly related to index procedure (16.7%).
Conclusions: Strict adherence to NSQIP definitions results in misidentification of true uROR. This raises concerns for using NSQIP-identified uROR as a hospital quality metric. Improved processes of care to prevent infection and hemorrhage at our institution could reduce the rate of true uROR.
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http://dx.doi.org/10.1016/j.amjsurg.2016.10.021 | DOI Listing |
Arch Bone Jt Surg
January 2024
Montefiore Medical Center - Department of Orthopedic Surgery, Bronx, New York, USA.
Objectives: Return to the Emergency Department (ED) within 90-days following arthroscopic shoulder surgery represents a potential source of increased healthcare expenditures. Understanding the risk factors could bring about interventions aimed at reducing its prevalence.
Methods: A retrospective review of all shoulder arthroscopies undertaken at a single academic institution from February 2016 through November 2023 was performed.
J Trauma Acute Care Surg
January 2025
From the Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY.
Background: Extracorporeal membrane oxygenation (ECMO) has emerged as a critical intervention in the management of patients with trauma-induced cardiorespiratory failure. This study aims to compare outcomes in patients with severe thoracic injuries with and without venovenous extracorporeal membrane oxygenation (VV-ECMO).
Methods: We performed a retrospective cohort study on Trauma Quality Improvement Program (2017-2021) and included all patients with isolated blunt thoracic injuries with Abbreviated Injury Scale score of ≥4 who required intubation.
Glob Health Action
December 2024
Health Management and Policy Institute, School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
Background: Unplanned readmissions among patients with mental and behavioural disorders (MBDs) disrupt inpatient recovery and impose financial burdens on families and healthcare systems.
Objectives: To estimate the 31-day unplanned inpatient readmission rates for MBDs in China and identify determinant profiles from the perspective of individual, hospital, and contextual levels.
Methods: Data from patients with MBDs were collected from the medical records of 99 public hospitals across 10 cities.
JSES Int
November 2024
Department of Orthopaedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Background: The incidence of primary reverse total shoulder arthroplasty (rTSA) and the prevalence of obesity have increased in the United States. Despite this, the literature assessing the effect of morbid obesity (body mass index≥40 kg/m) on perioperative surgical outcomes remains inconsistent.
Methods: A retrospective review of consecutive elective primary rTSA cases from January 2016 through September 2023 at a single tertiary referral center was performed.
BMC Anesthesiol
January 2025
Department of Nephrology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany.
Introduction: Acute kidney injury (AKI) is a common complication of acute respiratory distress syndrome (ARDS) and multiple organ dysfunction syndrome (MODS) in patients receiving extracorporeal membrane oxygenation (ECMO) support, leading to requirement of continuous renal replacement therapy (CRRT) in 70% of ECMO patients. Parallel arrangement of CRRT and ECMO circuits is common in adult patients. However, CRRT may also be integrated directly into the ECMO circuit.
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