title: Risk assessment in ginecology and obstetrics in Sicily: an approach based on Wolff's Criteria.
abstract: OBJECTIVE
  To apply Wolff's Criteria to hospital discharge records (HDR) in order to detect adverse events worthy of further study.
  
  
  METHODS
  Gynecology and Obstetrics Units of three Sicilian hospitals were considered and HDR regarding ordinary and day hospital admissions in 2008 were collected. A matched case-control study was designed, by random selection of 10 controls at maximum for each case. Matching was performed on the variables age and speciality of admission (gynecology or obstetrics).
  
  
  RESULTS
  Out of a total of 7011 HDR examined, 114 cases were identified with Wolff's Criteria. Multivariate analysis confirmed a statistically significant association with the origin of admission, diagnosis at the acceptance and length of stay: there was a decreased risk of Wolff's event in patients having urgent admission compared to elective (OR = 0.47, 95% CI = [0.28-0.78]), an increased risk in patients reporting tumor (OR = 5:41, 95 % CI [1.89-15.47]) and other causes (OR = 2.16, 95% CI [1.10-4.24]) compared to delivery diagnosis at acceptance and in patients whose length of stay was more than 6 days (OR = 23.17, 95% CI = [12.56-42.7]) compared to less or equal than 3 days
  
  
  CONCLUSIONS
  Wolff's Criteria can be applied for the analysis of clinical risk in hospitals with different structural characteristics, on condition that the HDR database is complete and good quality.
authors.affiliation: Sciences for Health Promotion and Mother and Children Health Department, University of Palermo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Matranga
authors.forename: M G L
authors.initials: MG
authors.lastname: Marsala
authors.forename: M
authors.initials: M
authors.lastname: Vadalà
authors.forename: M
authors.initials: M
authors.lastname: Morici
authors.forename: V
authors.initials: V
authors.lastname: Restivo
authors.forename: C
authors.initials: C
authors.lastname: Ferrara
authors.forename: F
authors.initials: F
authors.lastname: Vitale
authors.forename: A
authors.initials: A
authors.lastname: Firenze
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004630:Emergencies / Q000453:epidemiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology; D013509:Gynecologic Surgical Procedures / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007558:Italy; D007902:Length of Stay / Q000706:statistics & numerical data; D009775:Obstetrics and Gynecology Department, Hospital / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D061214:Patient Safety / Q000592:standards; D010360:Patient Transfer / Q000706:statistics & numerical data; D011247:Pregnancy; D015995:Prevalence; D058996:Quality Improvement; D012086:Reoperation / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods* / Q000592:standards; D012307:Risk Factors; D012308:Risk Management / Q000592:standards