Evaluating Metrics for Quality: Death on the Same Day of Elective Pediatric Surgery
Evaluating Metrics for Quality: Death on the Same Day of Elective Pediatric Surgery
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DOI：
10.1177/1062860611423727
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发表时间：
2012-05-01
影响因子：
1.4
通讯作者：
Abdullah, Fizan
中科院分区：
文献类型：
--
作者：
Chang, David C.;Rhee, Daniel S.;Abdullah, Fizan
手术死亡率被认为是衡量护理质量的基准。这项研究量化了择期儿科手术当天的死亡发生率，这通常被认为是可以预防的，可能被认为是“永远不会”的事件。作者对1988-2007年间国家住院病人数据库进行了回顾分析，其中包括选择的儿科外科病人。通过人口学、外科专业和年龄对当日死亡率进行描述性分析。在确认的835 880例儿科择期手术病例中，174名患者在手术当天死亡--即每10 000例中有2.1例死亡。外科专业死亡率为每10 000例中0.06例(耳鼻咽喉科)至17.4例(心胸外科)。择期儿科手术当天死亡的情况很少见，这限制了其在儿科手术中比较表现的实用性。然而，这一指标在个别机构可能是有用的，作为在质量改进工作中进行根本原因分析的案例查找工具。
Surgical mortality is considered a benchmark for measuring quality of care. This study quantifies the incidence of death on the day of elective pediatric surgery, which generally is considered preventable and might be considered a "never" event. The authors conducted a retrospective analysis of national state inpatient databases from 1988 to 2007 that included elective pediatric surgical patients. A descriptive analysis of same-day mortality by demographics, surgical specialties, and age was performed. Of 835 880 elective pediatric surgical cases identified, 174 patients died on the day of surgery-that is, 2.1 deaths/10 000 cases. Surgical specialty mortality rates ranged from 0.06 (otolaryngology) to 17.4 (cardiothoracic surgery) deaths per 10 000 cases. Death on the day of elective pediatric surgery is rare, limiting its utility to compare performance in pediatric surgery. However, this metric may be useful at individual institutions as a case-finding tool for root-cause analysis in quality improvement efforts.