Details

Autor(en) / Beteiligte

• Villodre, C.
• Taccogna, L.
• Zapater, P.
• Cantó, M.
• Mena, L.
• Ramia, J.M.
• Lluís, F.
• Afonso, N.
• Aguilella, V.
• Aguiló, J.
• Alados, J.C.
• Alberich, M.
• Apio, A.B.
• Balongo, R.
• Bra, E.
• Bravo-Gutiérrez, A.
• Briceño, F.J.
• Cabañas, J.
• Cánovas, G.
• Caravaca, I.
• Carbonell, S.
• Carrera-Dacosta, E.
• Castro E, E.
• Caula, C.
• Choolani-Bhojwani, E.
• Codina, A.
• Corral, S.
• Cuenca, C.
• Curbelo-Peña, Y.
• Delgado-Morales, M.M.
• Delgado-Plasencia, L.
• Doménech, E.
• Estévez, A.M.
• Feria, A.M.
• Gascón-Domínguez, M.A.
• Gianchandani, R.
• González, C.
• Hevia, R.J.
• González, M.A.
• Hidalgo, J.M.
• Lainez, M.
• Lluís, N.
• López, F.
• López-Fernández, J.
• López-Ruíz, J.A.
• Lora-Cumplido, P.
• Madrazo, Z.
• Marchena, J.
• Marenco de la Cuadra, B.
• Martín, S.
• Casas, I. Martínez
• Martínez, P.
• Mena-Mateos, A.
• Morales-García, D.
• Mulas, C.
• Muñoz-Forner, E.
• Naranjo, A.
• Navarro-Sánchez, A.
• Oliver, I.
• Ortega, I.
• Ortega-Higueruelo, R.
• Ortega-Ruiz, S.
• Osorio, J.
• Padín, M.H.
• Pamies, J.J.
• Paredes, M.
• Pareja-Ciuró, F.
• Parra, J.
• Pérez-Guarinós, C.V.
• Pérez-Saborido, B.
• Pintor-Tortolero, J.
• Plua-Muñiz, K.
• Rey, M.
• Rodríguez, I.
• Ruiz, C.
• Ruíz, R.
• Ruiz, S.
• Sánchez, A.
• Sánchez, D.
• Sánchez, R.
• Sánchez-Cabezudo, F.
• Sánchez-Santos, R.
• Santos, J.
• Serrano-Paz, M.P.
• Soria-Aledo, V.
• Tallón-Aguilar, L.
• Valdivia-Risco, J.H.
• Vallverdú-Cartié, H.
• Varela, C.
• Villar-del-Moral, J.
• Zambudio, N.

Titel

Simplified risk-prediction for benchmarking and quality improvement in emergency general surgery. Prospective, multicenter, observational cohort study

Ist Teil von

• International journal of surgery (London, England), 2022-01, Vol.97, p.106168-106168, Article 106168

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2022

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures. Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator. A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101–500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500–1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity. This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement. •The best benchmark cut-offs in Emergency General Surgery are unknown.•The present study established benchmark cut-off values in a low-risk cohort.•Benchmark cut-off was ≥40.9% for use of laparoscopy, and ≤3 days for hospital stays.•Benchmark cut-off was ≤17.7% for 30-day morbidity, and ≤1.1% for 30-day mortality.•These cut-offs values may guide quality improvement in Emergency General Surgery.