Overman David M, Jacobs Jeffrey P, Prager Richard L, Wright Cameron D, Clarke David R, Pasquali Sara K, O'Brien Sean M, Dokholyan Rachel S, Meehan Paul, McDonald Donna E, Jacobs Marshall L, Mavroudis Constantine, Shahian David M
The Children's Heart Clinic, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN 55404, USA.
World J Pediatr Congenit Heart Surg. 2013 Jan;4(1):10-2. doi: 10.1177/2150135112461924.
Several distinct definitions of postoperative death have been used in various quality reporting programs. Some have defined postoperative mortality as the occurrence of death after a surgical procedure when the patient dies while still in the hospital, while others have considered all deaths occurring within a predetermined, standardized time interval after surgery to be postoperative mortality. While mortality data are still collected and reported using both these individual definitions, the Society of Thoracic Surgeons (STS) believes that either approach alone may be inadequate. Accordingly, the STS prefers a more encompassing metric, Operative Mortality. Operative Mortality is defined in all STS databases as (1) all deaths, regardless of cause, occurring during the hospitalization in which the operation was performed, even if after 30 days (including patients transferred to other acute care facilities); and (2) all deaths, regardless of cause, occurring after discharge from the hospital, but before the end of the 30th postoperative day. This article provides clarification for some uncommon but important scenarios in which the correct application of this definition may be challenging.
在各种质量报告项目中，术后死亡有几种不同的定义。一些人将术后死亡率定义为手术过程后患者仍在医院时发生的死亡，而另一些人则认为在手术后预定的标准化时间间隔内发生的所有死亡均为术后死亡率。虽然仍在使用这两种单独的定义来收集和报告死亡率数据，但胸外科医师协会（STS）认为，仅采用这两种方法中的任何一种可能都不够。因此，STS更喜欢一种更具包容性的指标，即手术死亡率。在所有STS数据库中，手术死亡率的定义为：（1）在进行手术的住院期间发生的所有死亡，无论原因如何，即使是在30天之后（包括转至其他急性护理机构的患者）；以及（2）出院后但在术后第30天结束前发生的所有死亡，无论原因如何。本文对一些不常见但重要的情况进行了说明，在这些情况下正确应用此定义可能具有挑战性。
