Failure to rescue in emergency general surgery in Canada.

Autor:	Minor S; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball) samuel_minor@hotmail.com., Allen L; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Meschino MT; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Nenshi R; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., van Heest R; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Saleh F; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Widder S; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Engels PT; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Joos E; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Parry NG; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Murphy PB; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Ball CG; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Hameed M; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball)., Vogt KN; From the Department of Surgery, Dalhousie University, Halifax, NS (Minor, Meschino, Nenshi); the Department of Surgery, Western University, London, Ont. (Allen, Parry, Vogt); the Department of Surgery, William Osler Health System, Brampton, Ont. (van Heest, Saleh); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); the Department of Surgery, University of British Columbia, Vancouver, BC (Joos, Hameed); the Department of Surgery, Indiana University, Indianapolis, Ind. (Murphy); and the Department of Surgery, University of Calgary, Calgary, Alta. (Ball).
Jazyk:	angličtina
Zdroj:	Canadian journal of surgery. Journal canadien de chirurgie [Can J Surg] 2022 Mar 22; Vol. 65 (2), pp. E215-E220. Date of Electronic Publication: 2022 Mar 22 (Print Publication: 2022).
DOI:	10.1503/cjs.008820
Abstrakt:	Background: The risk of death after a postoperative complication - known as failure to rescue (FTR) - has been proposed to be superior to traditional benchmarking outcomes, such as complication and mortality rates, as a measure of system quality. The purpose of this study was to identify the current FTR rate in emergency general surgery (EGS) centres across Canada. We hypothesized that substantial variability exists in FTR rates across centres. Methods: In this multicentre retrospective cohort study, we performed a secondary analysis of data from a previous study designed to evaluate operative intervention for nonappendiceal, nonbiliary disease by 6 EGS services across Canada (1 in British Columbia, 1 in Alberta, 3 in Ontario and 1 in Nova Scotia). Patients underwent surgery between Jan. 1 and Dec. 31, 2014. We conducted univariate analyses to compare patients with and without complications. We performed a sensitivity analysis examining the mortality rate after serious complications (Clavien-Dindo score 3 or 4) that required a surgical intervention or specialized care (e.g., admission to intensive care unit). Results: A total of 2595 patients were included in the study cohort. Of the 206 patients who died within 30 days, 145 (70.4%) experienced a complication before their death. Overall, the mortality rate after any surgical complication (i.e., FTR) was 16.0%. Ranking of sites by the traditional outcomes of complication and mortality rates differed from the ranking when FTR rate was included in the assessment. Conclusion: There was variability in FTR rates across EGS services in Canada, which suggests that there is opportunity for ongoing quality-improvement efforts. This study provides FTR benchmarking data for Canadian EGS services. Competing Interests: Competing interests: Chad Ball is coeditor-in-chieif of CJS, and Paul Engels, Neil Parry and Kelly Vogt are associate editors. They were not involved in the editorial decision-making process for this article. No other competing interests were declared. (© 2022 CMA Impact Inc. or its licensors.)
Databáze:	MEDLINE
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