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Phase of care mortality analysis and failure to rescue in a Norwegian cardiothoracic unit

Authors :
Øystein Pettersen
Alexander Wahba
Roar Stenseth
Øystein Karlsen
Benedikte Therese Smenes
Source :
Scandinavian Cardiovascular Journal. 53:220-224
Publication Year :
2019
Publisher :
Informa UK Limited, 2019.

Abstract

Objectives. Two tools to categorize and present quality data, phase of care mortality analysis (POCMA) and failure to rescue (FTR) have been introduced in the cardiothoracic surgical environment, but not tested in Scandinavia. We aimed to investigate whether these tools could be used in a Norwegian patient population and to increase the understanding of why patients die after cardiac surgery. Design. A group of four, including one senior cardiothoracic surgeon and one senior anesthesiologist, scrutinized deaths within 30 days after cardiac surgery at the Clinic of Cardiothoracic Surgery, St. Olav's University Hospital, Norway between February 2012-October 2015 in line with the POCMA-methodology. We used the clinic's internal register to identify patients and utilized all available written information from each patient course. We decided whether each death was surgeon dependent, FTR or a result of a multifactorial etiology, and evaluated the strength of our decisions. Results. We identified 51 deaths out of 1983 operations in our study period, giving unadjusted mortality of 2.6%. Nine deaths were classified as surgeon dependent, 3 FTR and 39 multifactorial. Conclusions. POCMA- and FTR-analyses can be carried out in clinical data which is well documented. The operating surgeon is in many cases not responsible for operative mortality, very few die due to FTR, but most patients die due to a multifactorial etiology.

Details

ISSN :
16512006 and 14017431
Volume :
53
Database :
OpenAIRE
Journal :
Scandinavian Cardiovascular Journal
Accession number :
edsair.doi.dedup.....4d4a6441d3a67d79c585e14db68fea6e
Full Text :
https://doi.org/10.1080/14017431.2019.1628294