Surgical Rescue in a High-volume Urban Emergency General Surgery Service at a Middle-income Country
Fecha
2021Autor
Resumen
.
Abstract
Introduction: The capacity for prompt “rescue” from death in patients with complications has become an important marker of the quality of
care since mortality and morbidity have been identified as incongruous indicators. This study aims to describe the incidence of “surgical rescue”
failure and the outcomes of emergency general surgery (EGS) patients at a large academic medical center.
Materials and methods: In our high-volume surgical hospital, an electronic EGS registry was developed to automatically capture in-hospital
information and outcomes from the Electronic Medical Record (EMR). Surgical complications were included in an online application and
automatically captured in the electronic EGS registry, and prospectively screened from June to July 2017 for acute EGS surgical patients from
operative procedures.
Results: A total of 501 patients (average age: 53.9 ± 20.9, 56.5% female) underwent 882 EGS procedures. Thirteen patients (2.6%) of the 501
patients required “surgical rescue”, mainly for uncontrolled sepsis (43%) and anastomotic leakage (30%). The surgical rescue failure rate (inability
to prevent death after a surgical complication) was 15.4%. Patients requiring critical care (OR = 3.3, IC 95%: 1.04, 10.5), hospital admission
(p = 0.038), and hospital LOS (days) (p = 0.004) were significantly higher for the surgical rescue patients than for those without complications.
Conclusion: Surgical failure to rescue rate was similar among high-volume EGS services, as has recently been described in the United States.
The latest development and implementation of an electronic automatic captured EGS registry database in our academic medical center will
serve to build best practices for “surgical rescue” and drive quality improvement programs.
Keywords
URI
http://repositorio.mederi.com.co/handle/123456789/639https://web.archive.org/web/20210517051631id_/https://www.pajtcces.com/doi/pdf/10.5005/jp-journals-10030-1305
Colecciones
- Investigación clínica [389]