Vinsas Janušonis
Abstract
The aim of the study was to evaluate the contingent of patients who underwent a reoperation, the surgery profile their caus al factors, risks, the avoidance possibilities, and to compare the repeat surgery assessments made by surgeons and experts. Material and methods. From January 2000 to December 2014 a survey was carried out in Klaipeda University Hospital. The study included 757 inpatients, who underwent a reoperation. The data was collected via adverse event (reoperation) reporting forms. The findings of surgeons and experts estimations of reoperations according to surgery profile, patients’ age and gender during the periods of 2000-2004, 2005-2009 and 2010-2014 were analized and compared. Results. The research showed that reoperation was carried out on 0.31% of the surgery patients. More than one quarter (27.7%) of all adverse events were repeat surgery (reoperations). The greatest number of reoperations was abdominal and endocrine profile surgery (58.8%) of the average risk (51.7%). Many patients (39.8%) who underwent a reoperation had oncology diseases, part (11.2%) of them had links with infection. The main cause of repeat surgery was individual characteristics of patients (85.3% by surgeons’ and 89.6% by experts’ assessments). Most of reoperations (60.2% in surgeons’ and 66.7% experts’ opinion) were totally or partly avoidable.Conclusions. The main repeat surgery indicators – causes, degree of risk, the period of time between operation and reoperation – assessment of surgeons and experts were similar in the analysed periods. The part of repeat surgery in a high operation activity Klaipeda University Hospital with a large multi-profile developed infrastructure, providing the around the clock emergency medical care, was small and relatively stable. The main reason of reoperations was patients’ individual characteristics. The part (two- fifth) of the patients had oncology diseases, one of six reoperations had links with infection. The increase of the operational activity, the number of operations, and the operations complexity results in the increase of the repeat surgery and risk degree. The majority (two- thirds) of the reoperations could have been avoided with the application of multivalent prevention measures.
Keyword(s): repeat surgery; health care quality; adverse events.
DOI: 10.5200/sm-hs.2015.065
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