Postoperative Adverse Events of Common Surgical Procedures in the Medicare Population
Bibliographic Data
| ID | 9099265 |
|---|---|
| Authors | Amy K Rosen (0000-0002-7539-7749, Boston University, corresponding author), Jane M Geraci (Baylor College of Medicine, corresponding author), Arlene S Ash (0000-0002-8448-0253, University Medical Center, corresponding author), Kathleen J McNiff (Boston University), Mark A Moskowitz (Boston University, corresponding author) |
| Year | 1992 |
| Volume | 30 |
| Issue | 9 |
| Pages | 753-765 |
| Publication date | 1992-09-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/00005650-199209000-00001 |
| PMID | 1518309 |
| OpenAlex | W2054862371 |
| Language | EN |
| Citations received | 8 |
| References cited | 7 |
Mortality rates are the most widely used measure in assessing patient outcome from hospitalization. However, they may be an insensitive measure of quality for surgical patients because death is a relatively rare outcome. A random sample of patient data (n = 8126) selected from the Medicare files of seven states was used to identify, through chart abstraction, clinical postoperative complications of surgery that could serve as measures of quality. Four surgical procedures were studied: 1) coronary artery bypass grafting; 2) coronary angioplasty; 3) cholecystectomy; and 4) prostatectomy. Severity at admission was controlled for using severity-of-illness models developed with chart-abstracted data to predict adverse events after these four procedures. 30-day mortality rates ranged from 1.0% to 6.6%, while the prevalence of postoperative adverse events identified from chart review was greater (6.9% to 33.3%). There were significant differences between patients with and without adverse events. For example, coronary artery bypass graft patients with adverse events had prolonged postsurgical lengths of stay (18.5 +/- 13.2 vs. 13.2 +/- 6.2, P less than 0.001) and higher mortality rates (15.2% vs. 2.6%, P less than 0.001). The R-square values using clinical indicators at admission to predict the occurrence of any adverse event ranged from 0.05 to 0.13. Clinically meaningful adverse events of surgery can be successfully identified through chart abstraction and appear to be valid measures of postoperative complications among surgical patients. Severity adjustment at admission only modestly predicts the occurrence of these adverse events
Adverse effect · Angioplasty · Chart · Population · Prostatectomy · Cardiac, Anesthesia and Surgical Outcomes · Emergency Medicine · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Internal Medicine · Medicine · Surgery
In-Hospital Complication Occurrence as a Screen for Quality-of-Care Problems
The Risk of Adjustment
Profiling Outcomes of Ambulatory Care
Did Postoperative Mortality Increase After the Implementation of the Medicare Balanced Budget Act
Comorbidity-Adjusted Complication Risk
Can Administrative Data Be Used to Compare Postoperative Complication Rates Across Hospitals
Prediction Rules for Complications in Coronary Bypass Surgery
A Spurious Correlation Between Hospital Mortality and Complication Rates
Should Operations Be Regionalized?
Hospital Characteristics and Mortality Rates
The meaning and use of the area under a receiver operating characteristic (ROC) curve.
Admission and mid-stay MedisGroups scores as predictors of death within 30 days of hospital admission
Geographic variations in elderly hospital and surgical discharge rates, New York State
Using Clinical Variables to Estimate the Risk of Patient Mortality
The Condition of the Literature on Differences in Hospital Mortality
| Unique citing works | 8 |
|---|---|
| Citations per year | 0,24 |
| Citation span | 1992 - 2006 (15) |
| Citation velocity | historical |
| Highly cited | No |
| Citation types | Neutral: 6 |