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手术核对表及其完成情况对紧急结直肠手术并发症和死亡率的影响。

Impact of surgical checklist and its completion on complications and mortality in urgent colorectal procedures.

机构信息

- Prefeitura de Belo Horizonte, Secretaria Municipal de Saúde - Belo Horizonte - MG - Brasil.

- University of Ottawa, School of Nursing - Ottawa - Ontario - Canadá.

出版信息

Rev Col Bras Cir. 2021 Dec 20;48:e20213031. doi: 10.1590/0100-6991e-20213031. eCollection 2021.

Abstract

OBJECTIVE

to assess the impact of using a surgical checklist and its completion on complications such as surgical site infection (SSI), reoperation, readmission, and mortality in patients subjected to urgent colorectal procedures, as well as the reasons for non adherence to this instrument in this scenario, in a university hospital in Ottawa, Canada.

METHODS

this is a retrospective, epidemiological study. We collected data from an electronic database containing information on patients undergoing urgent colorectal operations, and analyzed the occurrence of SSI, reoperation, readmission, and death in a 30 day period, as well as the completion of the checklist. We conducted a descriptive statistical analysis and logistic regression.

RESULTS

we included 5,145 records, of which 5,083 (98.8%) had complete checklists. As for the outcomes evaluated, cases with complete checklists displayed higher SSI rate, 9.1% vs. 6.5% (p=0.466), lower reoperation rate, 5% vs.11.3% (p=0.023), lower readmission rates, 7.2% vs. 11.3% (p=0.209), and lower mortality, 3.0% vs. 6.5% (p=0.108) than cases with incomplete ones.

CONCLUSION

there was a high level of checklist completion and a larger number of the outcomes in the reduced percentage of incomplete checklists found, demonstrating the impact of its utilization on the safety of patients undergoing urgent operations.

摘要

目的

评估在加拿大渥太华的一所大学医院中,使用手术核对表及其完成情况对接受紧急结肠直肠手术的患者的并发症(如手术部位感染 [SSI]、再次手术、再入院和死亡率)的影响,以及在这种情况下不遵守该工具的原因。

方法

这是一项回顾性、流行病学研究。我们从一个包含接受紧急结肠直肠手术患者信息的电子数据库中收集数据,并分析了 30 天内 SSI、再次手术、再入院和死亡的发生情况,以及核对表的完成情况。我们进行了描述性统计分析和逻辑回归分析。

结果

我们纳入了 5145 份记录,其中 5083 份(98.8%)有完整的核对表。在评估的结果方面,完成核对表的病例显示出更高的 SSI 发生率,9.1%比 6.5%(p=0.466),更低的再次手术率,5%比 11.3%(p=0.023),更低的再入院率,7.2%比 11.3%(p=0.209),以及更低的死亡率,3.0%比 6.5%(p=0.108),而不完整核对表的病例发生率则更高。

结论

核对表的完成率很高,不完整核对表的比例更小,但发现的结果数量更多,这表明其使用对接受紧急手术的患者的安全有影响。

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