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Retained surgical items after abdominal and pelvic surgery: Incidence, trend and predictors- observational study

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Surgical retained items (RSIs) are associated with increase in perioperative morbidity and mortality. We used a large national database to investigate the incidence, trends and possible predictors for RSIs after major abdominal and pelvic procedures.

Methods: The nationwide inpatient sample data were queried to identify patients who underwent major abdominal and pelvic procedures and discharged with secondary ICD-9-CM diagnosis code of (998.44 and 998.7). McNemar's tests and conditional logistic regression analyses of a 1:1 matched sample were conducted to explore possible predictive factors for RSI.

Results: RSI incidence rate was 13 in 100,000 cases-years from 2007 to 2011 after major abdominal and pelvic procedures. RSI incidence remained steady over the five-year study period. Rural hospitals and elective procedures were associated with a higher RSI incidence rate [(OR 1.391, 95% CL 1.056–1.832), p = 0.019] and [(OR 1.775, 95%CL 1.501–2.098), p < 0.001] respectively.

Conclusions: Our study was able to add more to the epidemiological perspective and the risk profile of retained surgical items in abdominal and pelvic surgery. Surgical cases associated with these factors may need further testing to rule out RSI.

No MeSH data available.


Retained surgical items occurrence relationship to various factors, RN%(staff) = the percentage of registered nurses in the hospital of the total hospital nursing staff.
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fig2: Retained surgical items occurrence relationship to various factors, RN%(staff) = the percentage of registered nurses in the hospital of the total hospital nursing staff.

Mentions: After matching some of these differences dissipated in the propensity-matched sample (Fig. 2). In particular, the association between the likelihood of RSI incident and morbid obesity [(OR 1.254, 95%CL 0.880–1.785), p = 0.244] and teaching hospitals [(OR 1.081, 95%CL 0.917–1.274), p = 0.378] becames non-significant (Fig. 2). However, rural hospitals, compared to urban hospitals, were associated with a higher RSI incidence rate [(OR 1.391, 95% CL 1.056–1.832), p = 0.019]. Additionally, elective procedures were still associated with higher incidence of RSI in the propensity matched sample [(OR 1.775, 95%CL 1.501–2.098), p < 0.001]. Hospital bedsize had no effect on the incidence of RSI in the propensity matched sample. The odds ratio for RSI in small hospitals compared to large hospitals was [(OR 1.037, 95% CL 0.792–1.359), p = 0.848] and that for medium size hospitals was [(OR 1.135, 95% CL 0.920–1.399), p = 0.355]. Similarly, hospital ownership and control had no significant association with the RSI incidence. Compared to for-profit private hospitals, public hospitals had an OR of 1.216 [(OR 1.216, 95%CL 0.852–1.736), p = 0.203] while that for the not-for-profit private hospital was 1.032 [(OR 1.032, 95%CL 0.775–1.374), p = 0.538]. Furthermore, the percentage of registered nurses (RN) (compared to other nursing staff) in the hospital had no effects on the RSI rate when it was evaluated in the matched sample [(OR 0.988, 95%CL 0.974–1.002), p = 0.090].


Retained surgical items after abdominal and pelvic surgery: Incidence, trend and predictors- observational study
Retained surgical items occurrence relationship to various factors, RN%(staff) = the percentage of registered nurses in the hospital of the total hospital nursing staff.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121141&req=5

fig2: Retained surgical items occurrence relationship to various factors, RN%(staff) = the percentage of registered nurses in the hospital of the total hospital nursing staff.
Mentions: After matching some of these differences dissipated in the propensity-matched sample (Fig. 2). In particular, the association between the likelihood of RSI incident and morbid obesity [(OR 1.254, 95%CL 0.880–1.785), p = 0.244] and teaching hospitals [(OR 1.081, 95%CL 0.917–1.274), p = 0.378] becames non-significant (Fig. 2). However, rural hospitals, compared to urban hospitals, were associated with a higher RSI incidence rate [(OR 1.391, 95% CL 1.056–1.832), p = 0.019]. Additionally, elective procedures were still associated with higher incidence of RSI in the propensity matched sample [(OR 1.775, 95%CL 1.501–2.098), p < 0.001]. Hospital bedsize had no effect on the incidence of RSI in the propensity matched sample. The odds ratio for RSI in small hospitals compared to large hospitals was [(OR 1.037, 95% CL 0.792–1.359), p = 0.848] and that for medium size hospitals was [(OR 1.135, 95% CL 0.920–1.399), p = 0.355]. Similarly, hospital ownership and control had no significant association with the RSI incidence. Compared to for-profit private hospitals, public hospitals had an OR of 1.216 [(OR 1.216, 95%CL 0.852–1.736), p = 0.203] while that for the not-for-profit private hospital was 1.032 [(OR 1.032, 95%CL 0.775–1.374), p = 0.538]. Furthermore, the percentage of registered nurses (RN) (compared to other nursing staff) in the hospital had no effects on the RSI rate when it was evaluated in the matched sample [(OR 0.988, 95%CL 0.974–1.002), p = 0.090].

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Surgical retained items (RSIs) are associated with increase in perioperative morbidity and mortality. We used a large national database to investigate the incidence, trends and possible predictors for RSIs after major abdominal and pelvic procedures.

Methods: The nationwide inpatient sample data were queried to identify patients who underwent major abdominal and pelvic procedures and discharged with secondary ICD-9-CM diagnosis code of (998.44 and 998.7). McNemar's tests and conditional logistic regression analyses of a 1:1 matched sample were conducted to explore possible predictive factors for RSI.

Results: RSI incidence rate was 13 in 100,000 cases-years from 2007 to 2011 after major abdominal and pelvic procedures. RSI incidence remained steady over the five-year study period. Rural hospitals and elective procedures were associated with a higher RSI incidence rate [(OR 1.391, 95% CL 1.056&ndash;1.832), p&nbsp;=&nbsp;0.019] and [(OR 1.775, 95%CL 1.501&ndash;2.098), p&nbsp;&lt;&nbsp;0.001] respectively.

Conclusions: Our study was able to add more to the epidemiological perspective and the risk profile of retained surgical items in abdominal and pelvic surgery. Surgical cases associated with these factors may need further testing to rule out RSI.

No MeSH data available.