PDF(Pubmed)
Abstract：
BACKGROUND: Although elective procedures have life-changing potential, all surgeries come with an inherent risk of reoperation. There is a gap in knowledge investigating the risk of reoperation across orthopaedics. We aimed to identify the elective orthopaedic procedures with the highest rate of unplanned reoperation and the reasons for these procedures having such high reoperation rates.
METHODS: Patients in the NSQIP database were identified using CPT and ICD-10 codes. We isolated 612,815 orthopaedics procedures from 2018 to 2020 and identified the 10 CPT codes with the greatest rate of unplanned return to the operating room. For each index procedure, we identified the ICD-10 codes for the reoperation procedure and categorized them into infection, mechanical failure, fracture, wound disruption, hematoma or seroma, nerve pathology, other, and unspecified.
RESULTS: Below knee amputation (BKA) (CPT 27880) had the highest reoperation rate of 6.92% (37 of 535 patients). Posterior-approach thoracic (5.86%) or cervical (4.14%) arthrodesis and cervical laminectomy (3.85%), revision total hip arthroplasty (5.23%), conversion to total hip arthroplasty (4.33%), and revision shoulder arthroplasty (4.22%) were among the remaining highest reoperation rates. The overall leading causes of reoperation were infection (30.1%), mechanical failure (21.1%), and hematoma or seroma (9.4%) for the 10 procedures with the highest reoperation rates.
CONCLUSIONS: This study successfully identified the elective orthopaedic procedures with the highest 30-day return to OR rates. These include BKA, posterior thoracic and cervical spinal arthrodesis, revision hip arthroplasty, revision total shoulder arthroplasty, and cervical laminectomy. With this data, we can identify areas across orthopaedics in which revising protocols may improve patient outcomes and limit the burden of reoperations on patients and the healthcare system. Future studies should focus on the long-term physical and financial impact that these reoperations may have on patients and hospital systems.
METHODS: IV.
METHODS: Patients in the NSQIP database were identified using CPT and ICD-10 codes. We isolated 612,815 orthopaedics procedures from 2018 to 2020 and identified the 10 CPT codes with the greatest rate of unplanned return to the operating room. For each index procedure, we identified the ICD-10 codes for the reoperation procedure and categorized them into infection, mechanical failure, fracture, wound disruption, hematoma or seroma, nerve pathology, other, and unspecified.
RESULTS: Below knee amputation (BKA) (CPT 27880) had the highest reoperation rate of 6.92% (37 of 535 patients). Posterior-approach thoracic (5.86%) or cervical (4.14%) arthrodesis and cervical laminectomy (3.85%), revision total hip arthroplasty (5.23%), conversion to total hip arthroplasty (4.33%), and revision shoulder arthroplasty (4.22%) were among the remaining highest reoperation rates. The overall leading causes of reoperation were infection (30.1%), mechanical failure (21.1%), and hematoma or seroma (9.4%) for the 10 procedures with the highest reoperation rates.
CONCLUSIONS: This study successfully identified the elective orthopaedic procedures with the highest 30-day return to OR rates. These include BKA, posterior thoracic and cervical spinal arthrodesis, revision hip arthroplasty, revision total shoulder arthroplasty, and cervical laminectomy. With this data, we can identify areas across orthopaedics in which revising protocols may improve patient outcomes and limit the burden of reoperations on patients and the healthcare system. Future studies should focus on the long-term physical and financial impact that these reoperations may have on patients and hospital systems.
METHODS: IV.
摘要：
背景：尽管选修程序具有改变生活的潜力，所有手术都有再次手术的固有风险。在调查骨科再次手术风险的知识方面存在差距。我们旨在确定非计划再手术率最高的选择性骨科手术，以及这些手术具有如此高的再手术率的原因。
方法：使用CPT和ICD-10代码对NSQIP数据库中的患者进行鉴定。从2018年到2020年，我们隔离了612815个骨科手术，并确定了10个无计划返回手术室率最高的CPT代码。对于每个索引过程，我们确定了再手术的ICD-10代码，并将其分类为感染，机械故障,骨折,伤口破裂，血肿或血清肿，神经病理学，other,和未指定。
结果：膝关节以下截肢（BKA）（CPT27880）的再手术率最高，为6.92％（535例患者中有37例）。后路胸椎（5.86%）或颈椎（4.14%）关节固定术和颈椎椎板切除术（3.85%），翻修全髋关节置换术（5.23%），转换为全髋关节置换术（4.33%），和翻修肩关节置换术（4.22％）是其余最高的再手术率。再次手术的总体主要原因是感染（30.1%），机械故障（21.1%），再手术率最高的10例手术和血肿或血清肿（9.4％）。
结论：本研究成功确定了30天OR率最高的择期骨科手术。其中包括BKA,后胸椎和颈椎关节固定术，髋关节翻修术,翻修全肩关节置换术，和颈椎椎板切除术.有了这些数据,我们可以确定骨科的领域，在这些领域中，修订协议可以改善患者的预后，并限制患者和医疗保健系统的再手术负担。未来的研究应集中在这些再操作可能对患者和医院系统产生的长期身体和财务影响上。
方法：IV.
方法：使用CPT和ICD-10代码对NSQIP数据库中的患者进行鉴定。从2018年到2020年，我们隔离了612815个骨科手术，并确定了10个无计划返回手术室率最高的CPT代码。对于每个索引过程，我们确定了再手术的ICD-10代码，并将其分类为感染，机械故障,骨折,伤口破裂，血肿或血清肿，神经病理学，other,和未指定。
结果：膝关节以下截肢（BKA）（CPT27880）的再手术率最高，为6.92％（535例患者中有37例）。后路胸椎（5.86%）或颈椎（4.14%）关节固定术和颈椎椎板切除术（3.85%），翻修全髋关节置换术（5.23%），转换为全髋关节置换术（4.33%），和翻修肩关节置换术（4.22％）是其余最高的再手术率。再次手术的总体主要原因是感染（30.1%），机械故障（21.1%），再手术率最高的10例手术和血肿或血清肿（9.4％）。
结论：本研究成功确定了30天OR率最高的择期骨科手术。其中包括BKA,后胸椎和颈椎关节固定术，髋关节翻修术,翻修全肩关节置换术，和颈椎椎板切除术.有了这些数据,我们可以确定骨科的领域，在这些领域中，修订协议可以改善患者的预后，并限制患者和医疗保健系统的再手术负担。未来的研究应集中在这些再操作可能对患者和医院系统产生的长期身体和财务影响上。
方法：IV.
