title: Retained surgical items after abdominal and pelvic surgery: Incidence, trend and predictors- observational study.
abstract: BACKGROUND
  Surgical retained items (RSIs) are associated with increase in perioperative morbidity and mortality. We used a large national database to investigate the incidence, trends and possible predictors for RSIs after major abdominal and pelvic procedures.
  
  
  METHODS
  The nationwide inpatient sample data were queried to identify patients who underwent major abdominal and pelvic procedures and discharged with secondary ICD-9-CM diagnosis code of (998.44 and 998.7). McNemar's tests and conditional logistic regression analyses of a 1:1 matched sample were conducted to explore possible predictive factors for RSI.
  
  
  RESULTS
  RSI incidence rate was 13 in 100,000 cases-years from 2007 to 2011 after major abdominal and pelvic procedures. RSI incidence remained steady over the five-year study period. Rural hospitals and elective procedures were associated with a higher RSI incidence rate [(OR 1.391, 95% CL 1.056-1.832), p = 0.019] and [(OR 1.775, 95%CL 1.501-2.098), p < 0.001] respectively.
  
  
  CONCLUSIONS
  Our study was able to add more to the epidemiological perspective and the risk profile of retained surgical items in abdominal and pelvic surgery. Surgical cases associated with these factors may need further testing to rule out RSI.
authors.affiliation: Department of Anesthesiology and Pain Management at University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9068, USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Elsharydah
authors.affiliation: Department of Anesthesiology and Pain Management at University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9068, USA.
authors.forename: Kimberly O
authors.initials: KO
authors.lastname: Warmack
authors.affiliation: Department of Anesthesiology and Pain Management at University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9068, USA; Department of Clinical Sciences, Division of Biostatistics at University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9068, USA.
authors.forename: Abu
authors.initials: A
authors.lastname: Minhajuddin
authors.affiliation: Department of Surgery, Division of Thoracic Surgery at Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210-1240, USA.
authors.forename: Susan D
authors.initials: SD
authors.lastname: Moffatt-Bruce
keywords: Never event; Retained surgical item; Sentinel event; Unretrieved surgical device