THE INCIDENCE OF PERIOPERATIVE ADVERSE EVENTS AND RISK FACTORS ON INPATIENT MORBIDITY- A NATIONWIDE CROSS-SECTIONAL OBSERVATIONAL STUDY FROM TAIWAN
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 38
Abstract
BACKGROUND Research on perioperative adverse events has been challenged by varying definitions, reporting failure, scarce incidence or incomplete data collection. Insights into patient mortality and causes of death might improve surgical safety and quality of care. The aim of the present study is to analyse the characteristics and factors associated with prognosis (inpatient mortality) of surgery related injuries. MATERIALS AND METHODS Data was sourced from the Taiwanese National Health Insurance Research Database for the period of 1997 - 2008; SPSS 18.0 software was used to carry out statistical analysis. Surgery-related injuries were categorised according to ICD-9-CM classifications. RESULTS Each year, an average of 797 people are hospitalised in Taiwan due to surgery-related injuries. Males and females accounted for 46.19% and 53.81% of these hospitalisations, respectively. The predominant surgery-related injury events occurred in medical centres (57.89%) and surgery departments (37.71%). The first leading cause of surgery-related injury events was “unintentional cut, puncture, perforation or haemorrhage” (70.59%), but the highest rate of inpatient mortality resulted from “mismatched blood, fluid or substance in transfusion” (4.12%). The average age of male patients (55.97 yrs.) was significantly higher than females (50.99 yrs.). The highest percentage of surgery-related injury events for males was surgery (1.45 per 100,000) and 3.09 times more than those in females that were obstetrics and gynaecology related (0.47 per 100,000). “Unintentional cut, puncture, perforation or haemorrhage” (OR= 6.486), “older patient” (OR +3.8% per increased age) and “younger doctor” (OR +3.3% per increased age) might increase the risk of inpatient mortality. CONCLUSION The rate of in-hospital surgery-related injury was 64.55 per 100,000 and exhibited an upward trend. We should make improvement plans for doctors with higher rates of incidences in order to improve the safety of patients.
Authors and Affiliations
Yu-Pin Feng, Chi-Hsiang Chung, Wu-Chien Chien
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