Prognostic analysis of unplanned reoperation in Department of General Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Longlong ¹ , FAN Qiang ^1,2 , GU Yuelei ¹ ,  YANG Sunhu ¹

1. Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201999, P. R. China;
2. Bengbu Medical College, Bengbu, Anhui 233003, P. R. China;

Corresponding author：

YANG Sunhu, Email: yangsh06@126.com

Keywords：

unplanned reoperation; prognosis; risk factor

DOI：

10.7507/1007-9424.201709013

Video：

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Objective To explore prognostic factors of unplanned reoperation in Department of General Surgery. Methods The clinical data of 85 patients with unplanned reoperations who treated in the Northern District of the Shanghai Ninth People’s Hospital from January 2014 to May 2017 were retrospectively collected. The risk factors such as preoperative basic information, surgical related information, and postoperative information for death of unplanned reoperations were analyzed. Results There were 72 cured patients and 12 deaths in the 85 patients. The univariate analysis results showed that the age was older (P<0.05), the operative time was longer (P<0.05) in the patients with death as compared with the cured patients; the with basic diseases, selective operation, high grade of ASA, preoperative hemoglobin <90 g/L, admission to ICU after unplanned reoperations, postoperative complications, and multiple reoperations were correlated with the mortality of unplanned reoperations (P<0.05). The multivariate analysis results showed that the elderly patients, preoperative hemoglobin <90 g/L, and postoperative complications were the independent prognostic factors (P<0.05). The satisfaction of patients at discharge in the death group was significantly lower than that in the survival group (P<0.05). Conclusion Ederly patient, preoperative hemoglobin <90 g/L, and postoperative complications are independent prognostic factors of unplanned reoperations in Department of General Surgery.

Citation： ZHANG Longlong, FAN Qiang, GU Yuelei, YANG Sunhu. Prognostic analysis of unplanned reoperation in Department of General Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(3): 317-322. doi: 10.7507/1007-9424.201709013 Copy

1.	Ansari MZ, Collopy BT. The risk of an unplanned return to the operating room in Australian hospitals. Aust N Z J Surg, 1996, 66(1): 10-13.
2.	Kroon HM, Breslau PJ, Lardenoye JW. Can the incidence of unplanned reoperations be used as an indicator of quality of care in surgery? Am J Med Qual, 2007, 22(3): 198-202.
3.	王筱慧, 肖立宁, 鞠金涛, 等. 某医院非计划二次手术临床分析. 解放军医院管理杂志, 2010, 17(10): 959-961.
4.	王冠英, 王宏斌, 郑新瑞, 等. 非计划二次手术监控的实践与思考. 中国医院, 2013, (08): 26-27.
5.	Nandipati K, Lin E, Husain F, et al. Factors predicting the increased risk for return to the operating room in bariatric patients: a NSQIP database study. Surg Endosc, 2013, 27(4): 1172-1177.
6.	Rama-Maceiras P, Rey-Rilo T, Moreno-Lopez E, et al. Unplanned surgical reoperations in a tertiary hospital: perioperative mortality and associated risk factors. Eur J Anaesthesiol, 2011, 28(1): 10-15.
7.	Guevara OA, Rubio-Romero JA, Ruiz-Parra AI. Unplanned reoperations: is emergency surgery a risk factor? A cohort study. J Surg Res, 2013, 182(1): 11-16.
8.	Lin Y, Meguid RA, Hosokawa PW, et al. An institutional analysis of unplanned return to the operating room to identify areas for quality improvement. Am J Surg, 2017, 214(1): 1-6.
9.	郑新瑞, 金霞, 李晓康, 等. 非计划二次手术应对策略. 中华医院管理杂志, 2014, 30(9): 662-665.
10.	中华人民共和国卫生部. 医疗技术临床应用管理办法. 卫医政发, 2009-3-2.
11.	赵佳, 徐长妍, 刘玉霞, 等. 某大学三所附属医院手术分级管理现况调查. 中国病案, 2015 (2): 18-20.
12.	李响. 美国麻醉医师协会分级在老年肝癌患者外科治疗风险评估中的作用. 实用老年医学, 2015, 29(9): 755-758.
13.	Ploeg AJ, Lange CP, Lardenoye JW, et al. The incidence of unplanned returns to the operating room after peripheral arterial bypass surgery and its value as indicator of quality of care. Vasc Endovascular Surg, 2008, 42(1): 19-24.
14.	Michaels AD, Mullen MG, Guidry CA, et al. Unplanned Reoperation Following Colorectal Surgery: Indications and Operations. J Gastrointest Surg, 2017, 21(9): 1480-1485.
15.	任全海, 史卫海, 叶年源, 等. 普外科 58 例非计划二次手术临床分析. 中国卫生标准管理, 2016, 7(19): 37-38.
16.	Li P, Huang CM, Tu RH, et al. Risk factors affecting unplanned reoperation after laparoscopic gastrectomy for gastric cancer: experience from a high-volume center. Surg Endosc, 2017, 31(10): 3922-3931.
17.	裴建奎, 谢会平. 内镜下消化道肿瘤 1816 例性别年龄分布分析. 中国社区医师: 医学专业, 2013 (6): 364-365.
18.	王蓓, 吕成余, 谢洪虎. 351 例胃癌术后患者的预后因素分析. 中国普外基础与临床杂志, 2012, 19(7): 743-748.
19.	刘子君. 超高龄患者外科手术治疗的思考. 医学与哲学: 临床决策论坛版, 2009 (8): 51-52.
20.	丁友宏, 胡鹏涛, 严士光, 等. 超高龄胃癌患者的外科诊治体会. 现代仪器与医疗, 2016, 1: 014.
21.	宋彬, 苏妍卓, 舒振波, 等. 远端胃切除术后胃瘫综合征的危险因素分析. 中国普外基础与临床杂志, 2016, 23(1): 94-96.
22.	曹海生, 关利响. 中下段直肠癌行低位前切除术后吻合口瘘发生的相关因素探讨. 中国普通外科杂志, 2012, 21(10): 1300-1303.
23.	刘洪. 术前营养风险与直肠癌前切除术后吻合口瘘的相关性分析. 南方医科大学 2013.
24.	马睿, 倪妍. 4 例非计划二次手术的临床分析及处理. 医学美学美容 (中旬刊), 2015, (3): 608-608.
25.	Birkmeyer JD, Hamby LS, Birkmeyer CM, et al. Is unplanned return to the operating room a useful quality indicator in general surgery? Arch Surg, 2001, 136(4): 405-411.
26.	邓金和, 贺繁荣, 招伟贤. 胃肠手术患者术前贫血与术后并发症的关系. 广东医学, 2017, 38(6): 900-902.
27.	Crookes B, Osler T. Variability in reoperation rates at 182 hospitals: a potential target for quality improvement. J Am Coll Surg, 2010, 210(4): 533-534.
28.	Dierks MM, Huang ZS, Siracuse JJ, et al. Diagnostic, surgical judgment, and systems issues leading to reoperation: mining administrative databases. Am J Surg, 2010, 199(3): 324-329.
29.	Dillström M, Bjerså K, Engström M. Patients’ experience of acute unplanned surgical reoperation. J Surg Res, 2017, 209: 199-205.
30.	Thomsen T, Vester-Andersen M, Nielsen MV, et al. Patients’ experiences of postoperative intermediate care and standard surgical ward care after emergency abdominal surgery: a qualitative sub-study of the Incare trial. J Clin Nurs, 2015, 24(9-10): 1280-1288.
31.	Xu P, Fan Z, Li T, et al. Preventing surgical disputes through early detection and intervention: a case control study in China. BMC Health Serv Res, 2015, 15: 5.

1. Ansari MZ, Collopy BT. The risk of an unplanned return to the operating room in Australian hospitals. Aust N Z J Surg, 1996, 66(1): 10-13.
2. Kroon HM, Breslau PJ, Lardenoye JW. Can the incidence of unplanned reoperations be used as an indicator of quality of care in surgery? Am J Med Qual, 2007, 22(3): 198-202.
3. 王筱慧, 肖立宁, 鞠金涛, 等. 某医院非计划二次手术临床分析. 解放军医院管理杂志, 2010, 17(10): 959-961.
4. 王冠英, 王宏斌, 郑新瑞, 等. 非计划二次手术监控的实践与思考. 中国医院, 2013, (08): 26-27.
5. Nandipati K, Lin E, Husain F, et al. Factors predicting the increased risk for return to the operating room in bariatric patients: a NSQIP database study. Surg Endosc, 2013, 27(4): 1172-1177.
6. Rama-Maceiras P, Rey-Rilo T, Moreno-Lopez E, et al. Unplanned surgical reoperations in a tertiary hospital: perioperative mortality and associated risk factors. Eur J Anaesthesiol, 2011, 28(1): 10-15.
7. Guevara OA, Rubio-Romero JA, Ruiz-Parra AI. Unplanned reoperations: is emergency surgery a risk factor? A cohort study. J Surg Res, 2013, 182(1): 11-16.
8. Lin Y, Meguid RA, Hosokawa PW, et al. An institutional analysis of unplanned return to the operating room to identify areas for quality improvement. Am J Surg, 2017, 214(1): 1-6.
9. 郑新瑞, 金霞, 李晓康, 等. 非计划二次手术应对策略. 中华医院管理杂志, 2014, 30(9): 662-665.
10. 中华人民共和国卫生部. 医疗技术临床应用管理办法. 卫医政发, 2009-3-2.
11. 赵佳, 徐长妍, 刘玉霞, 等. 某大学三所附属医院手术分级管理现况调查. 中国病案, 2015 (2): 18-20.
12. 李响. 美国麻醉医师协会分级在老年肝癌患者外科治疗风险评估中的作用. 实用老年医学, 2015, 29(9): 755-758.
13. Ploeg AJ, Lange CP, Lardenoye JW, et al. The incidence of unplanned returns to the operating room after peripheral arterial bypass surgery and its value as indicator of quality of care. Vasc Endovascular Surg, 2008, 42(1): 19-24.
14. Michaels AD, Mullen MG, Guidry CA, et al. Unplanned Reoperation Following Colorectal Surgery: Indications and Operations. J Gastrointest Surg, 2017, 21(9): 1480-1485.
15. 任全海, 史卫海, 叶年源, 等. 普外科 58 例非计划二次手术临床分析. 中国卫生标准管理, 2016, 7(19): 37-38.
16. Li P, Huang CM, Tu RH, et al. Risk factors affecting unplanned reoperation after laparoscopic gastrectomy for gastric cancer: experience from a high-volume center. Surg Endosc, 2017, 31(10): 3922-3931.
17. 裴建奎, 谢会平. 内镜下消化道肿瘤 1816 例性别年龄分布分析. 中国社区医师: 医学专业, 2013 (6): 364-365.
18. 王蓓, 吕成余, 谢洪虎. 351 例胃癌术后患者的预后因素分析. 中国普外基础与临床杂志, 2012, 19(7): 743-748.
19. 刘子君. 超高龄患者外科手术治疗的思考. 医学与哲学: 临床决策论坛版, 2009 (8): 51-52.
20. 丁友宏, 胡鹏涛, 严士光, 等. 超高龄胃癌患者的外科诊治体会. 现代仪器与医疗, 2016, 1: 014.
21. 宋彬, 苏妍卓, 舒振波, 等. 远端胃切除术后胃瘫综合征的危险因素分析. 中国普外基础与临床杂志, 2016, 23(1): 94-96.
22. 曹海生, 关利响. 中下段直肠癌行低位前切除术后吻合口瘘发生的相关因素探讨. 中国普通外科杂志, 2012, 21(10): 1300-1303.
23. 刘洪. 术前营养风险与直肠癌前切除术后吻合口瘘的相关性分析. 南方医科大学 2013.
24. 马睿, 倪妍. 4 例非计划二次手术的临床分析及处理. 医学美学美容 (中旬刊), 2015, (3): 608-608.
25. Birkmeyer JD, Hamby LS, Birkmeyer CM, et al. Is unplanned return to the operating room a useful quality indicator in general surgery? Arch Surg, 2001, 136(4): 405-411.
26. 邓金和, 贺繁荣, 招伟贤. 胃肠手术患者术前贫血与术后并发症的关系. 广东医学, 2017, 38(6): 900-902.
27. Crookes B, Osler T. Variability in reoperation rates at 182 hospitals: a potential target for quality improvement. J Am Coll Surg, 2010, 210(4): 533-534.
28. Dierks MM, Huang ZS, Siracuse JJ, et al. Diagnostic, surgical judgment, and systems issues leading to reoperation: mining administrative databases. Am J Surg, 2010, 199(3): 324-329.
29. Dillström M, Bjerså K, Engström M. Patients’ experience of acute unplanned surgical reoperation. J Surg Res, 2017, 209: 199-205.
30. Thomsen T, Vester-Andersen M, Nielsen MV, et al. Patients’ experiences of postoperative intermediate care and standard surgical ward care after emergency abdominal surgery: a qualitative sub-study of the Incare trial. J Clin Nurs, 2015, 24(9-10): 1280-1288.
31. Xu P, Fan Z, Li T, et al. Preventing surgical disputes through early detection and intervention: a case control study in China. BMC Health Serv Res, 2015, 15: 5.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Prognostic analysis of unplanned reoperation in Department of General Surgery

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