From the Department of Surgery (J.S.H., C.E.S., A.E.G.W.), Division of Traumatology, Surgical Critical Care and Emergency Surgery (E.J.K., D.N.H.), Perelman School of Medicine at the University of Pennsylvania; and College of Arts and Sciences (L.M.), University of Pennsylvania Philadelphia, Pennsylvania.
J Trauma Acute Care Surg. 2019 Sep;87(3):699-706. doi: 10.1097/TA.0000000000002365.
The Failure to Rescue (FTR) rate is defined as the mortality rate among patients who experience one or more complications. It has been used as an outcome metric for approximately 25 years, primarily in elective surgery populations, and has been shown to be associated with factors that are modifiable on the institutional level. Although the FTR metric was derived in elective surgical populations, modifications have been made in attempts to refine the metric and apply it to broader populations, including medical patients and non-elective surgical patients. However, study among emergency general surgery patients has been limited. In this review, we summarize the current knowledge surrounding FTR, including established risk factors and potential limitations of the metric in emergency general surgery (EGS) populations. We then discuss a conceptual model for FTR events and review strategies to minimize rates. Finally, we provide a brief overview of current areas of study and potential future directions in acute care surgery.
抢救失败(FTR)率定义为经历一种或多种并发症的患者的死亡率。它已被用作大约 25 年来的结果指标,主要在择期手术人群中使用,并已证明与机构层面上可改变的因素相关。尽管 FTR 指标是在择期手术人群中得出的,但已经进行了修改,试图改进该指标并将其应用于更广泛的人群,包括内科患者和非择期手术患者。然而,在急诊普通外科患者中的研究有限。在这篇综述中,我们总结了 FTR 的现有知识,包括急诊普通外科(EGS)人群中已确定的危险因素和该指标的潜在局限性。然后,我们讨论了 FTR 事件的概念模型,并回顾了降低发生率的策略。最后,我们简要概述了急性护理外科领域的当前研究领域和潜在的未来方向。