Abstract:
INTRODUCTION:The quantification and analysis of adverse events is essential to benchmark surgical outcomes and establish a foundation for quality improvement interventions. We developed a hybrid electronic medical record (HEMR) system for the accurate collection and integration of data into a structured morbidity and mortality (M&M) meeting. METHODOLOGY:The HEMR system was implemented on January 1, 2013. It included a mechanism to capture and classify adverse events using the ICD-10 coding system. This was achieved by both prospective reporting by clients and by retrospective sentinel-event-trawling performed by administrators. RESULTS:From January 1, 2013 to March 20, 2014, 6,217 patients were admitted within the tertiary surgical service of Greys Hospital. A total of 1,314 (21.1 %) adverse events and 315 (5.1 %) deaths were recorded. The adverse events were divided into 875 "pathology-related" morbidities and 439 "error-related" morbidities. Pathology-related morbidities included 725 systemic complications and 150 operative complications. Error-related morbidities included 257 cognitive errors, 158 (2.5 %) iatrogenic injuries, and 24 (1.3 %) missed injuries. Error accounted for 439 (33 %) of the total number of adverse events. A total of 938 (71.4 %) adverse events were captured prospectively, whereas the remaining 376 (28.6 %) were captured retrospectively. The ICD-10 coding system was found to have some limitations in its classification of adverse events. CONCLUSIONS:The HEMR system has provided the necessary platform within our service to benchmark the incidence of adverse events. The use of the international ICD-10 coding system has identified some limitations in its ability to classify and categorise adverse events in surgery.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Laing G,Bruce J,Skinner D,Allorto N,Aldous C,Thomson S,Clarke Ddoi
10.1007/s00268-014-2766-xsubject
Has Abstractpub_date
2015-01-01 00:00:00pages
70-9issue
1eissn
0364-2313issn
1432-2323journal_volume
39pub_type
杂志文章abstract:BACKGROUND:Chronic pilonidal disease is a debilitating condition that typically affects young adults. There is a wide variety of available therapeutic strategies reflecting the inconsistent outcomes attributed to the various operative approaches. The majority involve excision of the sinus tract followed by either prima...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1138-z
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The external branch of the superior laryngeal nerve (EBSLN) is at surgical risk during superior thyroid pole ligation during thyroidectomy. Majority of studies have addressed the identification of these nerves and its reported incidence. Very few studies have addressed the relationship of these nerves with t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3383-z
更新日期:2016-03-01 00:00:00
abstract::Fifty patients reoperated for failed Nissen fundoplication are presented; 29 patients (group 2) were operated between 1983 and 1988 while 21 patients (group 1) were operated before 1983. In group 1, the "slipped Nissen" had been the most frequent cause of reoperation (48%). In group 2, the most frequent causes for the...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658439
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Patients with end-stage renal disease (ESRD) and secondary hyperparathyroidism (SHPT) are at high risk of mortality. Whether an increased risk of death persists after a parathyroidectomy (PTX) is not clearly established. SUBJECTS AND METHODS:The survival of 40 patients with ESRD and SHPT who underwent PTX w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0693-1
更新日期:2007-05-01 00:00:00
abstract:INTRODUCTION:The association between socioeconomic status (SES) and relative survival of rectal cancer is little investigated. We hypothesized that the impact on risk of death by SES would be much smaller when differences in background mortality (comorbidity, lifestyle factors) were taken into account, i.e. in modellin...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2735-4
更新日期:2014-12-01 00:00:00
abstract::The metabolic changes in cancer cachexia appear to be mediated by a complex network of proinflammatory cytokines, neuroendocrine hormones, neurotransmitters, eicosanoids, and tumor-derived factors produced by the body in response to the tumor and by the tumor itself. The relative importance of these various mediator p...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689910110
更新日期:2000-06-01 00:00:00
abstract::Enteral nutrition (EN) and total parenteral nutrition (TPN) may provide life-sustaining therapy for surgical patients. The duration of nutritional therapy (enteral or parenteral) implies distinct access routes. We review the main aspects related to access routes for nutrient delivery. The enteral route, whenever feasi...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010264
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Total thyroidectomy is a well-established surgical approach for the management of papillary thyroid cancer (PTC). However, the best surgical approach for papillary microcarcinoma is nowadays still debated. Both total thyroidectomy and simple lobectomy are used. We report the experience of a single University...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3327-7
更新日期:2016-03-01 00:00:00
abstract::The purpose of this study was to elucidate the function of the sphincter of Oddi (SO) in patients with juxtapapillary duodenal diverticula (JDDs). The SO function was evaluated by intraoperative biliary manometry in three groups of patients. Group 1 consisted of nine patients with JDDs and a dilated common bile duct (...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00308647
更新日期:1995-03-01 00:00:00
abstract::The expression of Fas ligand on tumor cells may counterattack the host's immunity and worsen the prognosis. Knowledge of the prognostic impact of Fas ligand on patients with hepatocellular carcinoma (HCC) after hepatectomy is still limited. Fas ligand expression in HCCs was examined in 59 patients who underwent hepate...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7254-2
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Nonoperative management (NOM) of kidney gunshot injuries as an alternative to surgical exploration is rarely reported. The aim of this study was to assess the feasibility and safety of selective NOM of such injuries. METHODS:A 4-year prospective study was conducted that included all patients admitted to a L...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9888-y
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (HPT) is often caused by a benign parathyroid tumor, adenoma; less commonly by multiglandular parathyroid disease/hyperplasia; and rarely by parathyroid carcinoma. Patients with multiple tumors require wider exploration to avoid recurrence and have increased risk for hereditary di...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-009-0022-6
更新日期:2009-11-01 00:00:00
abstract:INTRODUCTION:Sentinel lymph node biopsy (SLNB) is the standard of care for staging N0 primary early breast cancers (EBC). Patients in developing countries mostly present with large (LOBC) or locally advanced cancers (LABC) and are treated with neo-adjuvant chemotherapy (NACT). Accuracy of SLNB in staging stage III N0 a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3222-2
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Insertion of a nasogastric tube (NGT) in an anesthetized, paralyzed, and intubated patient is difficult, and many methods have been proposed to aid in the procedure. We present a simple insertion technique. METHODS:A silicone NGT was made rigid by filling it with distilled water and freezing it. Patients we...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-009-0144-x
更新日期:2009-09-01 00:00:00
abstract::Thyrotoxicosis is the clinical syndrome that results when tissues are exposed to high levels of circulating thyroid hormones. In most instances thyrotoxicosis is due to hyperthyroidism, a term reserved for disorders characterized by overproduction of thyroid hormones by the thyroid gland. Nevertheless, thyrotoxicosis ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002680010228
更新日期:2000-11-01 00:00:00
abstract::In 1947, a patient with metastatic islet cell tumor was treated for intractable ulcer disease at the University of Chicago Medical Center. Eight years later, in retrospect, it was recognized that he and another patient had the Zollinger-Ellison syndrome (ZE). From 1947 until the present, 30 patients with the ZE syndro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658530
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:This study compares survival in patients with the rare subtypes of follicular (FTmC) and Hurthle cell (HCmC) microcarcinoma compared to that of papillary thyroid (PTmC) microcarcinoma. METHODS:Patients with FTmC and HCmC were selected from the National Cancer Database 2004-2015 and compared with PTmC. Patie...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05264-9
更新日期:2020-02-01 00:00:00
abstract::The development of laparoscopic surgery has provided minimally invasive surgeons with advanced laparoscopic instrumentation and high definition imaging. The resulting surgical expertise and technology has now been extended to gastric endoluminal surgery. Laboratory and clinical investigations have been initiated for v...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/pl00012311
更新日期:1999-04-01 00:00:00
abstract::The rectal electrical activity recorded by electrorectogram (ERG) was studied in 22 chronically constipated subjects and 16 healthy volunteers. The latter had a mean (+/- SD) age of 42.6 +/- 8.5 years; 10 were men and 6 women. Of the 22 constipated patients, 14 had inertia-type constipation (IC; age 44.6 +/- 10.2 year...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00295930
更新日期:1995-09-01 00:00:00
abstract::This study assessed the results of surgical treatment for Graves' disease in our hospital and examined the relationship between the values of thyroid stimulating hormone (TSH) receptor antibodies and postoperative thyroid function. From 1983 to 1988, subtotal thyroidectomy was performed in 313 patients with Graves' di...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067345
更新日期:1992-07-01 00:00:00
abstract::In spite of recent therapeutic advances, severe overt secondary hyperparathyroidism due to chronic renal failure necessitates parathyroidectomy and recurrent hyperparathyroidism is one of the most significant problems in this patient population. In the present study, the incidence of recurrent hyperparathyroidism was ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067331
更新日期:1992-07-01 00:00:00
abstract:INTRODUCTION:Unilateral adrenal hyperplasia (UAH) is a rare, surgically correctable cause of primary hyperaldosteronism (PH). We report 2 cases and review the literature for cases of PH secondary to UAH successfully treated via surgery. METHODS:Two cases of UAH treated at our institution were retrospectively reviewed....
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0594-8
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Unilateral vocal fold paralysis (UVFP) may present as an uncommon complication of extralaryngeal neoplasms, requiring diagnostic scrutiny to seek occult tumors or diseases. The aim of this study was to examine the utility of computed tomography (CT) in evaluating adult UVFP of unknown etiology. METHODS:From...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-1991-z
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:Postoperative ascites (POA) is a common complication after liver resection (LR). The aim of the present study was to identify the risk factors for developing POA and to evaluate its clinical significance in the prognosis of patients with hepatocellular carcinoma (HCC). METHODS:We performed a retrospective a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1367-1
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:A recent analysis found bradycardia during laparoscopy as a potential early warning sign of cardiac arrest. Knowledge regarding bradycardia frequency and its consequences during laparoscopy is limited. METHODS:Using the computerized record database, files of 9915 patients undergoing laparoscopic surgery, be...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-04935-x
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:The adoption of robotic systems for gastric cancer surgery has been proven feasible and safe; however, a benefit over the laparoscopic approach has not yet been well-documented. We aimed to investigate the surgical outcomes of robotic versus laparoscopic gastrectomy for gastric cancer, according to the exten...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-2998-4
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:LLR is widely adapted for HCC, while LLR in PS segments is still challenging. With recent improvement of techniques and accumulation of experiences, LLR in PS segments is feasible, but studies investigating the result after the modifications are lacking. METHODS:In this single-center, retrospective study, 1...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05912-5
更新日期:2021-01-13 00:00:00
abstract:BACKGROUND:Selective nonoperative management (SNOM) of penetrating neck injuries (PNI) has steadily gained favor, but indications for surgery and adjunctive diagnostic studies remain debated. The purpose of the present study is to validate a protocol of SNOM of PNI based on physical examination, which further dictates ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9766-7
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND AND AIM:Previous studies have shown that microscopic vessel invasion (MVI) occurs in hepatocellular carcinoma (HCC) with a treatment history due to its poorer malignant behavior in comparison with primary HCC. The aim of the present study was to determine the predictors of MVI and overall survival in HCC pat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4658-y
更新日期:2018-11-01 00:00:00
abstract::The most common causes of variceal bleeding are cirrhosis, schistosomiasis, and extrahepatic portal venous obstruction. The prognosis for an individual patient depends on the severity of the bleeding episode and the underlying liver function. Liver function is determined to a large extent by the underlying liver patho...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00294397
更新日期:1994-03-01 00:00:00