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National Analysis of Adverse Patient Safety Events in Bariatric Surgery
- Source :
- The American Surgeon. 71:406-413
- Publication Year :
- 2005
- Publisher :
- SAGE Publications, 2005.
-
Abstract
- Identifying risk factors for adverse events after bariatric surgery (BaS) can help define high-risk groups to improve patient safety. We calculated cumulative incidence of adverse events and identified risk factors for these events using validated surgical patient safety indicators (PSIs) developed by the Agency for Healthcare Research and Quality. BaS patients ≥18 years old were identified using the 2002 Nationwide Inpatient Sample. Cumulative incidence at discharge was calculated for accidental puncture or laceration (APL), pulmonary embolus or deep venous thrombosis (PE/DVT), and postoperative respiratory failure (RF). Factors predictive of these PSIs were identified. From 7,853,982 discharges, a national cohort of 69,490 BaS patients was identified. During BaS hospitalization, the cumulative incidences per 1000 discharges of APL, PE/DVT, and RF were 12.6, 3.4, and 7.3, respectively. Risk factors for APL included male gender (odds ratio [OR] 1.6, 95% confidence interval 1.1–2.3, P < 0.05) and age of 40–49 years (OR 1.6 [1.1–2.3], P < 0.05) compared to ages 18–39 years. Patients aged 50–59 years (OR 3.5 [1.6–7.7], P < 0.05) had a higher chance of PE/DVT compared to those 18–39 years. Male gender (OR 1.8 [1.1–2.9], P < 0.05), ages 40–49 (OR 2.1 [1.1–4.2], P < 0.05) and 50–59 (OR 3.8 [2.1–6.9], P < 0.05), a history of chronic lung disease (OR 1.7 [1.1–2.7], P < 0.05), and Medicare coverage compared to private insurance (OR 2.2 [1.2–3.8], P < 0.05) were predictive of RF. This study established national measures for BaS adverse events. Further, risk factors associated with adverse events varied by gender, age, insurance status, and comorbidity. Evaluation of these higher risk BaS groups is needed to improve patient safety.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Patient safety
Bariatrics
Postoperative Complications
Risk Factors
Humans
Medicine
Cumulative incidence
Adverse effect
Digestive System Surgical Procedures
business.industry
Incidence
General Medicine
Odds ratio
Middle Aged
medicine.disease
Comorbidity
United States
Confidence interval
Surgery
Venous thrombosis
Respiratory failure
Female
Patient Care
Safety
business
Subjects
Details
- ISSN :
- 15559823 and 00031348
- Volume :
- 71
- Database :
- OpenAIRE
- Journal :
- The American Surgeon
- Accession number :
- edsair.doi.dedup.....b32a55e4723cb5b501dd58843d78744c