title: A Patient Safety Dilemma: Obesity in the Surgical Patient.
abstract: Patient safety and the delivery of quality care are major concerns for healthcare in the United States. Special populations (eg, obese patients) need study in order to support patient safety, quantify risks, advance education for healthcare-workers, and establish healthcare policy. Obesity is a complex chronic disease and is considered the second leading cause of preventable death in the United States with approximately 300,000 deaths per year. Obesity is recognized by the Agency for Healthcare Research and Quality (AHRQ) as a comorbid condition. These concerns emphasize the need to focus further research on the obese patient. Through the use of clinical and administrative data, this study examines the incidence of adverse outcomes in the obese surgical population through AHRQ Patient Safety Indicators (PSI) and allows for the engagement PSIs as measures to guide and improve performance. In this study, the surgical population was overwhelmingly positive for obesity. Body mass index (BMI) was also a significant positive predictor for 2 of 3 postoperative outcomes. This finding suggests that as BMI reaches the classification of obesity, the risk of these adverse outcomes increases. It further suggests there exists a threshold BMI that requires anticipation of alterations to systems and processes to revise outcomes.
authors.affiliation: Duke University School of Nursing, Durham, North Carolina.
authors.forename: Victoria
authors.initials: V
authors.lastname: Goode
authors.affiliation: University of Virginia School of Nursing, Charlottesville, Virginia.
authors.forename: Elayne
authors.initials: E
authors.lastname: Phillips
authors.affiliation: University of Virginia School of Nursing, Charlottesville, Virginia.
authors.forename: Pamela
authors.initials: P
authors.lastname: DeGuzman
authors.affiliation: University of Virginia School of Nursing, Charlottesville, Virginia.
authors.forename: Ivora
authors.initials: I
authors.lastname: Hinton
authors.affiliation: University of Virginia School of Nursing, Charlottesville, Virginia.
authors.forename: Virginia
authors.initials: V
authors.lastname: Rovnyak
authors.affiliation: University of Virginia School of Nursing, Charlottesville, Virginia.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Scully
authors.affiliation: Duke University School of Nursing, Durham, North Carolina.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Merwin
mesh_terms: D015992:Body Mass Index; D006801:Humans; D009765:Obesity / Q000453:epidemiology*; D061214:Patient Safety; D011183:Postoperative Complications / Q000453:epidemiology*; D019984:Quality Indicators, Health Care; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D014481:United States; D016270:United States Agency for Healthcare Research and Quality
keywords: AHRQ; obesity; patient safety; patient safety indicators; secondary data analysis