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, 肖立寧, 鞠金濤, 等. 某醫院非計劃二次手術臨床分析. 解放軍醫院管理雜志, 2010, 17(10): 959-961.
4.	王冠英, 王宏斌, 鄭新瑞, 等. 非計劃二次手術監控的實踐與思考. 中國醫院, 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.	鄭新瑞, 金霞, 李曉康, 等. 非計劃二次手術應對策略. 中華醫院管理雜志, 2014, 30(9): 662-665.
10.	中華人民共和國衛生部. 醫療技術臨床應用管理辦法. 衛醫政發, 2009-3-2.
11.	趙佳, 徐長妍, 劉玉霞, 等. 某大學三所附屬醫院手術分級管理現況調查. 中國病案, 2015 (2): 18-20.
12.	李響. 美國麻醉醫師協會分級在老年肝癌患者外科治療風險評估中的作用. 實用老年醫學, 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, 史衛海, 葉年源, 等. 普外科 58 例非計劃二次手術臨床分析. 中國衛生標準管理, 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, 謝會平. 內鏡下消化道腫瘤 1816 例性別年齡分布分析. 中國社區醫師: 醫學專業, 2013 (6): 364-365.
18.	王蓓, 呂成余, 謝洪虎. 351 例胃癌術后患者的預后因素分析. 中國普外基礎與臨床雜志, 2012, 19(7): 743-748.
19.	劉子君. 超高齡患者外科手術治療的思考. 醫學與哲學: 臨床決策論壇版, 2009 (8): 51-52.
20.	丁友宏, 胡鵬濤, 嚴士光, 等. 超高齡胃癌患者的外科診治體會. 現代儀器與醫療, 2016, 1: 014.
21.	宋彬, 蘇妍卓, 舒振波, 等. 遠端胃切除術后胃癱綜合征的危險因素分析. 中國普外基礎與臨床雜志, 2016, 23(1): 94-96.
22.	曹海生, 關利響. 中下段直腸癌行低位前切除術后吻合口瘺發生的相關因素探討. 中國普通外科雜志, 2012, 21(10): 1300-1303.
23.	劉洪. 術前營養風險與直腸癌前切除術后吻合口瘺的相關性分析. 南方醫科大學 2013.
24.	馬睿, 倪妍. 4 例非計劃二次手術的臨床分析及處理. 醫學美學美容 (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.	鄧金和, 賀繁榮, 招偉賢. 胃腸手術患者術前貧血與術后并發癥的關系. 廣東醫學, 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.	Dillstr?m M, Bjers? K, Engstr?m 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, 肖立寧, 鞠金濤, 等. 某醫院非計劃二次手術臨床分析. 解放軍醫院管理雜志, 2010, 17(10): 959-961.
4. 王冠英, 王宏斌, 鄭新瑞, 等. 非計劃二次手術監控的實踐與思考. 中國醫院, 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. 鄭新瑞, 金霞, 李曉康, 等. 非計劃二次手術應對策略. 中華醫院管理雜志, 2014, 30(9): 662-665.
10. 中華人民共和國衛生部. 醫療技術臨床應用管理辦法. 衛醫政發, 2009-3-2.
11. 趙佳, 徐長妍, 劉玉霞, 等. 某大學三所附屬醫院手術分級管理現況調查. 中國病案, 2015 (2): 18-20.
12. 李響. 美國麻醉醫師協會分級在老年肝癌患者外科治療風險評估中的作用. 實用老年醫學, 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, 史衛海, 葉年源, 等. 普外科 58 例非計劃二次手術臨床分析. 中國衛生標準管理, 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, 謝會平. 內鏡下消化道腫瘤 1816 例性別年齡分布分析. 中國社區醫師: 醫學專業, 2013 (6): 364-365.
18. 王蓓, 呂成余, 謝洪虎. 351 例胃癌術后患者的預后因素分析. 中國普外基礎與臨床雜志, 2012, 19(7): 743-748.
19. 劉子君. 超高齡患者外科手術治療的思考. 醫學與哲學: 臨床決策論壇版, 2009 (8): 51-52.
20. 丁友宏, 胡鵬濤, 嚴士光, 等. 超高齡胃癌患者的外科診治體會. 現代儀器與醫療, 2016, 1: 014.
21. 宋彬, 蘇妍卓, 舒振波, 等. 遠端胃切除術后胃癱綜合征的危險因素分析. 中國普外基礎與臨床雜志, 2016, 23(1): 94-96.
22. 曹海生, 關利響. 中下段直腸癌行低位前切除術后吻合口瘺發生的相關因素探討. 中國普通外科雜志, 2012, 21(10): 1300-1303.
23. 劉洪. 術前營養風險與直腸癌前切除術后吻合口瘺的相關性分析. 南方醫科大學 2013.
24. 馬睿, 倪妍. 4 例非計劃二次手術的臨床分析及處理. 醫學美學美容 (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. 鄧金和, 賀繁榮, 招偉賢. 胃腸手術患者術前貧血與術后并發癥的關系. 廣東醫學, 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. Dillstr?m M, Bjers? K, Engstr?m 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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