title: [Elective and acute procedures in trauma surgery. Complications requiring revision].
abstract: BACKGROUND
  Using data between 2010 and 31 March 2012, a cohort study concerning complications of all discharged patients who had undergone surgery was performed.
  
  
  METHODS
  In our detailed analysis, we defined two groups out of the 5,248 cases: an acute trauma patient group (n = 3,942) and an elective patient group (n = 1,306). Complications were divided into the following groups: (1) technical complications (failure of the implant, poor indication, instability or non-union), (2) local complication (hematoma or delayed wound healing), and (3) infection.
  
  
  RESULTS
  In 4.4% of patients (n = 233), treatment was delayed because of a complication. In 2.3% (n = 123), a technical complication was observed, followed by local complications in 1.3% [e.g., hematoma 0.6%, other wound healing disturbance (0.6%)]. In the elective surgery group, the percentage of complications needing revision (3.1%) was significantly lower compared to the trauma surgery group (4.9%). The patient's age for the non-complicated surgery group was significantly lower (54 vs. 63 years) and length of hospital stay (6.7 days longer) was significantly higher in patients with complications. Risk factors such as smoking were significantly more frequent in patients with complications (9% vs. 18.5%).
  
  
  CONCLUSIONS
  Recording and evaluating of complications in surgery plays a major role for quality control. Certain factors (e.g., comorbidity and the age of the patient) cannot be influenced, but complications caused by technical problems could theoretically be avoided. Especially these cases must be analyzed in detail to reduce the percentage of complications requiring revision.
authors.affiliation: Klinik und Poliklinik für Unfall- und Wiederherstellungschirurgie, Universitätsklinikum Carl Gustav Carus der TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland, wolfgang.schneiders@uniklinikum-dresden.de.
authors.forename: W
authors.initials: W
authors.lastname: Schneiders
authors.forename: S
authors.initials: S
authors.lastname: Lamping
authors.forename: S
authors.initials: S
authors.lastname: Rammelt
authors.forename: A
authors.initials: A
authors.lastname: Olbrich
authors.forename: H
authors.initials: H
authors.lastname: Zwipp
mesh_terms: D003422:Critical Care; D017558:Elective Surgical Procedures; D005260:Female; D005593:Fracture Fixation, Internal / Q000706:statistics & numerical data*; D050723:Fractures, Bone / Q000453:epidemiology* / Q000601:surgery*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000601:surgery*; D015995:Prevalence; D012086:Reoperation / Q000706:statistics & numerical data*; D012307:Risk Factors