Evidence map›Paper›PMID 37672166›Full record

SynthesisNeurosurgical review2023

Failure to rescue as a patient safety indicator for neurosurgical patients: are we there yet? A systematic review.

Joanna M Roy, Kavelin Rumalla, Georgios P Skandalakis, Syed Faraz Kazim, Meic H Schmidt, Christian A Bowers

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
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

6 authors.

Joanna M RoyTopiwala National Medical College, Mumbai, India.
Kavelin RumallaDepartment of Neurosurgery, University of New Mexico Hospital (UNMH), 1 University New Mexico, MSC10 5615, Albuquerque, NM, 87131, USA.
Georgios P SkandalakisDepartment of Neurosurgery, University of New Mexico Hospital (UNMH), 1 University New Mexico, MSC10 5615, Albuquerque, NM, 87131, USA.
Syed Faraz KazimDepartment of Neurosurgery, University of New Mexico Hospital (UNMH), 1 University New Mexico, MSC10 5615, Albuquerque, NM, 87131, USA.
Meic H SchmidtBowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM, 87131, USA.
Christian A BowersBowers Neurosurgical Frailty and Outcomes Data Science Lab, Albuquerque, NM, 87131, USA. christianbowers4@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Failure to rescue (FTR) is a standardized patient safety indicator (PSI-04) developed by the Agency for Healthcare Research and Quality (AHRQ) to assess the ability of a healthcare team to prevent mortality following a major complication. However, FTR rates vary and are impacted by non-modifiable individual patient characteristics such as baseline frailty. This raises concerns regarding the validity of FTR as an objective quality metric, as not all patients have the same baseline frailty level, or physiological reserve, to recover from major complications. Literature from other surgical specialties has identified flaws in FTR and called for risk-adjusted metrics. Currently, knowledge of factors influencing FTR and its subsequent implementation in neurosurgical patients are limited. The present review assesses trends in FTR utilization to assess how FTR performs as an objective neurosurgery quality metric. This review then proposes how FTR may be best modified to optimize use in neurosurgical patients. A PubMed search was performed to identify articles published until August 9, 2023. Studies that reported FTR as an outcome in patients undergoing neurosurgical procedures were included. A qualitative assessment was performed using the Newcastle Ottawa Scale (NOS). The initial search revealed 1232 citations. After a title and abstract screen, followed by a full text screen, 12 studies met criteria for inclusion. These articles measured FTR across a total of 764,349 patients undergoing neurosurgical procedures. Five studies analyzed FTR with regard to hospital characteristics, and three studies utilized patient characteristics to predict FTR. All studies were considered high quality based on the NOS. Modifications in criteria to measure FTR are necessary since FTR depends on patient characteristics like frailty. This would allow for the incorporation of risk-adjusted FTR metrics that would aid in clinical decision making in neurosurgical patients.

Indexed as

FrailtyNeurosurgeryClinical Decision-MakingHumansNeurosurgical ProceduresPatient SafetyUnited StatesFailure to rescueFrailtyOutcomes researchPatient safety indicator-04Quality improvement

Identifiers

PMID37672166

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.