December 4, 2014JAMA Surgery
Risk and Patterns of Secondary Complications in Surgical Inpatients
Why the study?
Does experiencing a first (index) postoperative complication increase the risk of specific secondary complications in patients undergoing elective inpatient surgery?
Population
890,604 patients undergoing elective inpatient surgery from January 1, 2005, through December 31, 2011…
Comparison
Experiencing a first postoperative complication vs Matched control patients without the index…
Design
Cohort
Follow-up
30-day
Authors
Discussion
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Member takes
Implication
Index postoperative MI may flag failure-to-rescue risk; supports pathway-targeted research but leaves open intervention effects.
Structured PICO
Does experiencing a first (index) postoperative complication increase the risk of specific secondary complications in patients undergoing elective inpatient surgery?
P
Population
890,604 patients undergoing elective inpatient surgery from January 1, 2005, through December 31, 2011, identified in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP).
I
Intervention
Experiencing a first (index) postoperative complication (pneumonia, acute myocardial infarction, deep space surgical site infection, bleeding or transfusion event, or acute renal failure)
C
Comparator
Matched control patients without the index complication, based on propensity for the index event and number of event-free days
O
Outcome
Rates of 30-day secondary complications and 30-day mortalityhard clinical
Experiencing a specific initial postoperative complication significantly increases the risk of distinct secondary complications, identifying clinical pathways that could be targeted to prevent failure to rescue.
Cite This Study
Wakeam et al. (2014) studied this question.