Failure to Rescue After Abdominal Surgery: an Audit on Incidence and Predictors

Authors

  • Narendra Pandit B.P. Koirala Institute of Health Sciences, Dharan, Nepal https://orcid.org/0000-0001-6904-7972
  • Kunal B Deo B.P. Koirala Institute of Health Sciences, Dharan, Nepal
  • Laligen Awale B.P. Koirala Institute of Health Sciences, Dharan, Nepal
  • Sameer Bhattarai B.P. Koirala Institute of Health Sciences, Dharan, Nepal
  • Tek Narayan Yadav B.P. Koirala Institute of Health Sciences, Dharan, Nepal

DOI:

https://doi.org/10.3126/jssn.v24i2.42830

Keywords:

Gastrointestinal Surgery, Hospital mortality, complications, failure to rescue

Abstract

Introduction: Failure-to-rescue (FTR), defined as death after a surgical complication, is a quality metric that is an important variable affecting mortality rates in hospitals. This study aims to analyze complications, FTR rates, and its predictors at the index hospital setting.

Methods: This was a retrospective cohort study performed at an academic  hospital from 2015 to 2020 in the Department of Surgical Gastroenterology. We included all patients who had major complications following elective major benign or malignant abdominal surgeries. The primary and secondary endpoint was FTR rates and the overall major complications and deaths, re-operation rate, and its predictors respectively.

Results: Among 762 patients, the rate of any major complication was 14.9% . The overall mortality rate was 2.8%. However, the mortality rate among patients with complications was 27.4% (FTR). Twenty-seven (52.9%) patients underwent re-operation for complications, out of which 70% survived. Three (21.4%) patients had a delay in prompt diagnosis and interventions of complications and had FTR due to the anastomotic leak and bleeding. The ASA grade, co-morbidities,, re-operation, and nature of the disease (benign vs. malignant) did not predict the FTR.

Conclusion: This study conducted at an academic, low-volume center had higher rates of FTR. It can be further reduced by both prompt and appropriate interventions of postoperative complications in a multidisciplinary setup.

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Author Biographies

Narendra Pandit, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Department of Gastrointestinal Surgery; and Birat Medical College Teaching Hospital, Biratnagar, Nepal

Kunal B Deo, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Department of Gastrointestinal Surgery

Laligen Awale, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Department of Gastrointestinal Surgery

Sameer Bhattarai, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Department of Gastrointestinal Surgery

Tek Narayan Yadav, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Department of Gastrointestinal Surgery

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Published

2021-12-31

How to Cite

Pandit, N., Deo, K. B., Awale, L., Bhattarai, S., & Yadav, T. N. (2021). Failure to Rescue After Abdominal Surgery: an Audit on Incidence and Predictors. Journal of Society of Surgeons of Nepal, 24(2), 42–45. https://doi.org/10.3126/jssn.v24i2.42830

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Section

Original Articles