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DC Field | Value | Language |
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dc.contributor.author | Divakaran, Pranav | - |
dc.contributor.author | Hong, Joshua Sungho | - |
dc.contributor.author | Abbas, Saleh | - |
dc.contributor.author | Gwini, Stella-May | - |
dc.contributor.author | Nagra, Sonalmeet | - |
dc.contributor.author | Stupart, Douglas | - |
dc.contributor.author | Guest, Glenn | - |
dc.contributor.author | Watters, David | - |
dc.date.accessioned | 2023-05-26T00:38:56Z | - |
dc.date.available | 2023-05-26T00:38:56Z | - |
dc.date.issued | 2023-05-24 | - |
dc.identifier.uri | https://repository.southwesthealthcare.com.au/swhealthcarejspui/handle/1/3892 | - |
dc.description.abstract | Background Failure to rescue (FTR) is increasingly recognised as a measure of the quality care provided by a health service in recognising and responding to patient deterioration. We report the association between a patient’s pre-operative status and FTR following major abdominal surgery. Methods A retrospective chart review was conducted on patients who underwent major abdominal surgery and who suffered Clavien–Dindo (CDC) III-V complications at the University Hospital Geelong between 2012 and 2019. For each patient suffering a major complication, pre-operative risk factors including demographics, comorbidities (Charlson Comorbidity Index (CCI)), American Society of Anaesthesiology (ASA) Score and biochemistry were compared for patients who survived and patients who died. Statistical analysis utilised logistic regression with results reported as odds ratios (ORs) and 95% confidence intervals (CIs). Results There were 2579 patients who underwent major abdominal surgery, of whom 374 (14.5%) suffered CDC III-V complications. Eighty-eight patients subsequently died from their complication representing a 23.5% FTR and an overall operative mortality of 3.4%. Pre-operative risk factors for FTR included ASA score ≥ 3, CCI ≥ 3 and pre-operative serum albumin of < 35 g/L. Operative risk factors included emergency surgery, cancer surgery, greater than 500 ml intraoperative blood loss and need for ICU admission. Patients who suffered end-organ failure were more likely to die from their complication. Conclusion Identification of patients at high risk of FTR should they develop a complication would inform shared decision-making, highlight the need for optimisation prior to surgery, or in some cases, result in surgery not being undertaken. | en |
dc.publisher | Springer | en |
dc.subject | Failure to Rescue | en |
dc.subject | Clavien–Dindo (CDC) III-V | en |
dc.subject | Surgery | en |
dc.title | Failure to Rescue in Major Abdominal Surgery: A Regional Australian Experience | en |
dc.type | Journal Article | en |
dc.identifier.journaltitle | World Journal of Surgery | en |
dc.accession.number | PMID: 37225931 | en |
dc.description.affiliation | Department of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia. Warrnambool Base Hospital, Southwest Healthcare, 25 Ryot Street, Warrnambool, VIC, 3280, Australia. Department of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia. Geelong Clinical School, Deakin University School of Medicine, Little Malop Street, Geelong, VIC, 3220, Australia. Biostatistics Support Service, Level 2 Kitchner House, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia. | en |
dc.identifier.importdoi | https://doi.org/10.1007/s00268-023-07061-x | en |
dc.contributor.swhauthor | Hong, Joshua Sungho | - |
Appears in Collections: | SWH Staff Publications |
Files in This Item:
File | Description | Size | Format | |
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World j surg - 2023 - Divakaran - Failure to Rescue in Major Abdominal Surgery A Regional Australian Experience.pdf | 114.17 kB | Adobe PDF | View/Open |
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