Association between intra-operative incidents and postoperative outcome and resource utilisation.
We assessed the predictive value of intra-operative quality indicators (incidents) with respect to outcome (hospital mortality) and resource utilisation (length of stay in the postanaesthesia care unit and in hospital). Institutional data obtained from reports of a quality system that complies with the ISO 9002 standard were evaluated retrospectively. Incidents occurred in 2009 of 25 091 anaesthetics. Mortality was higher after incidents than after uneventful anaesthetics, but in multivariate analysis the incidents did not contribute to mortality. Length of stay in the postanaesthesia care unit and hospital were longer after incidents (p < 0.001 for both). In multivariate analysis, incidents independently contributed to length of stay in the postanaesthesia care unit among ASA I-III patients (p < 0.05, 0.001 and 0.001, respectively) and to length of hospital stay among ASA II-III patients undergoing scheduled operations (p < 0.05 and < 0.01, respectively). Intra-operative incidents are associated with increased resource utilisation following surgery.
Niskanen
M M
MM
Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, PO Box 1777, FIN-70211 Kuopio, Finland.
Ruokonen
E T
ET
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000762:Anesthesia Recovery Period; D000765:Anesthesia, Conduction / Q000009:adverse effects; D005260:Female; D005387:Finland / Q000453:epidemiology; D006295:Health Resources / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D019984:Quality Indicators, Health Care; D011997:Recovery Room / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors