From the Department of Anesthesia, University of Iowa, Iowa City, Iowa.
A A Pract. 2024 Aug 23;18(8):e01841. doi: 10.1213/XAA.0000000000001841. eCollection 2024 Aug 1.
We evaluated whether a hospital-based anesthesia department can validly use automated intensive care unit (ICU) admission data after elective ambulatory procedures to assess the quality of anesthetic care. Among 13,656 patients, 25 (0.2%) had an unplanned hospital length of stay >1 night and ICU admission. On review, only 1 of the 25 cases (0.007%) had an anesthesia-related complication. The false-positive incidence of anesthetic complications was ≥96% for scheduled ambulatory cases with ICU admission. Therefore, fully automated computerized identification of all unexpected ICU admissions after ambulatory procedures without manual review is an unsuitable (invalid) metric of individual anesthesiologists' clinical performance.
我们评估了一家医院的麻醉部门是否可以有效地使用自动化重症监护病房（ICU）入院数据，以评估麻醉护理质量。在 13656 名患者中，有 25 名（0.2%）的非计划住院时间> 1 晚和 ICU 入院。经审查，只有 25 例中的 1 例（0.007%）存在麻醉相关并发症。对于计划进行日间手术且入住 ICU 的患者，麻醉并发症的假阳性发生率≥96%。因此，在没有人工审查的情况下，完全自动化的计算机识别所有意外的 ICU 入院，而不进行人工审查，是评估个别麻醉师临床表现的一种不合适（无效）的指标。
