Key result
Unplanned return to the operating room within 24 hours linked to ~138% higher mortality risk.
Why the study?
The study was conducted to identify the causes of and risk factors for unplanned return to the operating room within 24 hours in surgical patients.
What are the risk factors for unplanned return to the operating room within 24 hours in surgical patients?
Case-Control (n=344)
No
What are the risk factors for unplanned return to the operating room within 24 hours in surgical patients?
Hazard Ratio: 2.383 (95% CI 1.053–5.395)
Absolute Event Rate: 11.63% vs 5.23%
p-value: p=0.037
Preoperative identification of bleeding risk factors, including antiplatelet or anticoagulant use, is crucial to minimize unplanned returns to the operating room and associated mortality.
Unplanned 24-hour return to OR associated with higher mortality; leaves open whether mitigating bleeding risks improves survival.
The purpose of the retrospective case-control study was to identify the causes of and risk factors for unplanned return to the operating room (uROR) within 24 hours in surgical patients.We examined 275 cases of 24-hour uROR in our hospital from January 2010 to December 2018. The reasons for 24-hour uROR were classified into several categories. Controls were randomly matched to cases in a 1:1 ratio with the selection criteria set for the same surgeon and operation code in the same corresponding year.The mortality rate was significantly higher in patients with 24-hour uROR (11.63% vs 5.23%). Bleeding was the most common etiology (172/275; 62.55%) and technical error (14.5%) also contributed to 24-hour uROR. The clinical factors that led to bleeding included a history of liver disease (P = .032), smoking (P = .002), low platelet count in preoperative screening (P = .012), and preoperative administration of antiplatelet or anticoagulant agents (P = .014).Clinicians should recognize the risk factors for bleeding and minimize errors to avoid the increase in patient morbidity and mortality that is associated with 24-hour uROR.Level of Evidence: Level IV.
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Kao et al. (2021) conducted a case-control in Surgical complications (n=344). Unplanned return to the operating room within 24 hours vs. No unplanned return to the operating room was evaluated on Mortality rate (HR 2.383, 95% CI 1.053-5.395, p=0.037). Unplanned return to the operating room within 24 hours was associated with a significantly higher crude mortality rate compared to matched controls (11.63% vs 5.23%, HR 2.383).
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