Evidence map›Paper›PMID 37225931›Full record

ArticleWorld journal of surgery2023

Failure to Rescue in Major Abdominal Surgery: A Regional Australian Experience.

Pranav Divakaran, Joshua Sungho Hong, Saleh Abbas, Stella-May Gwini, Sonalmeet Nagra, Douglas Stupart, Glenn Guest, David Watters

Abstract read
In one paragraph

Article in World journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Pranav DivakaranDepartment of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia. pranav2160@gmail.com.ORCID 0000-0002-9683-9120
Joshua Sungho HongWarrnambool Base Hospital, Southwest Healthcare, 25 Ryot Street, Warrnambool, VIC, 3280, Australia.
Saleh AbbasDepartment of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia.
Stella-May GwiniBiostatistics Support Service, Level 2 Kitchner House, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia.
Sonalmeet NagraDepartment of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia.
Douglas StupartDepartment of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia.
Glenn GuestDepartment of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia.
David WattersDepartment of Surgery, University Hospital Geelong, Barwon Health 272-322 Bellarine Street and Ryrie Street, Geelong, VIC, 3220, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFailure to rescue (FTR) is increasingly recognised as a measure of the quality care provided by a health service in recognising and responding to patient deterioration. We report the association between a patient's pre-operative status and FTR following major abdominal surgery.

methodsA retrospective chart review was conducted on patients who underwent major abdominal surgery and who suffered Clavien-Dindo (CDC) III-V complications at the University Hospital Geelong between 2012 and 2019. For each patient suffering a major complication, pre-operative risk factors including demographics, comorbidities (Charlson Comorbidity Index (CCI)), American Society of Anaesthesiology (ASA) Score and biochemistry were compared for patients who survived and patients who died. Statistical analysis utilised logistic regression with results reported as odds ratios (ORs) and 95% confidence intervals (CIs).

resultsThere were 2579 patients who underwent major abdominal surgery, of whom 374 (14.5%) suffered CDC III-V complications. Eighty-eight patients subsequently died from their complication representing a 23.5% FTR and an overall operative mortality of 3.4%. Pre-operative risk factors for FTR included ASA score ≥ 3, CCI ≥ 3 and pre-operative serum albumin of < 35 g/L. Operative risk factors included emergency surgery, cancer surgery, greater than 500 ml intraoperative blood loss and need for ICU admission. Patients who suffered end-organ failure were more likely to die from their complication.

conclusionIdentification of patients at high risk of FTR should they develop a complication would inform shared decision-making, highlight the need for optimisation prior to surgery, or in some cases, result in surgery not being undertaken.

Indexed as

Failure to Rescue, Health CarePostoperative ComplicationsAustraliaHospital MortalityHumansRetrospective StudiesRisk Factors

Identifiers

PMID37225931
PMCPMC10208200

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.