Magouliotis Dimitrios E, Xanthopoulos Andrew, Zotos Prokopis-Andreas, Arjomandi Rad Arian, Tatsios Evangelos, Bareka Metaxia, Briasoulis Alexandros, Triposkiadis Filippos, Skoularigis John, Athanasiou Thanos
Unit of Quality Improvement, Department of Cardiothoracic Surgery, University of Thessaly, Biopolis, 41110 Larissa, Greece.
Department of Cardiology, University of Thessaly, Biopolis, 41110 Larissa, Greece.
J Clin Med. 2023 Jul 24;12(14):4876. doi: 10.3390/jcm12144876.
We conducted a thorough literature review on the emerging role of failure to rescue (FTR) as a quality metric for cardiovascular surgery and critical care. For this purpose, we identified all original research studies assessing the implementation of FTR in cardiovascular surgery and critical care from 1992 to 2023. All included studies were evaluated for their quality. Although all studies defined FTR as mortality after a surgical complication, a high heterogeneity has been reported among studies regarding the included complications. There are certain factors that affect the FTR, divided into hospital- and patient-related factors. The identification of these factors allowed us to build a stepwise roadmap to reduce the FTR rate. Recently, FTR has further evolved as a metric to assess morbidity instead of mortality, while being also evaluated in the context of interventional cardiology. All these advances are further discussed in the current review, thus providing all the necessary information to surgeons, anesthesiologists, and physicians willing to implement FTR as a metric of quality in their establishment.
我们针对未能成功挽救（FTR）作为心血管手术和重症监护质量指标的新兴作用进行了全面的文献综述。为此，我们确定了1992年至2023年期间所有评估FTR在心血管手术和重症监护中实施情况的原创性研究。对所有纳入研究的质量进行了评估。尽管所有研究都将FTR定义为手术并发症后的死亡率，但研究报告显示，在所纳入的并发症方面存在高度异质性。有某些因素会影响FTR，这些因素分为医院相关因素和患者相关因素。对这些因素的识别使我们能够构建一个逐步降低FTR率的路线图。最近，FTR已进一步演变为一种评估发病率而非死亡率的指标，同时也在介入心脏病学背景下进行评估。当前综述中进一步讨论了所有这些进展，从而为愿意将FTR作为其机构质量指标来实施的外科医生、麻醉师和医生提供所有必要信息。
