PDF(Pubmed)
Abstract：
UNASSIGNED: We aimed to evaluate the prevalence of highly detailed ventral hernia repair (VHR) operative reports and associations between operative report detail and postoperative outcomes in a medico-legal dataset.
UNASSIGNED: VHR are one of the most common surgical procedures performed in the United States. Previous work has shown that VHR operative reports are poorly detailed, however, the relationship between operative report detail and patient outcomes is unknown.
UNASSIGNED: This is a retrospective cross-sectional observational study. Operative reports describing VHR were obtained from a medical-legal database. Medical records were screened and data was extracted including clinical outcomes, such as surgical site infection (SSI), hernia recurrence, and reoperation and the presence of key details in each report. Highly detailed operative reports were defined as having 70% of recommended details. The primary outcome was the prevalence of highly detailed VHR operative reports.
UNASSIGNED: A total of 1011 VHR operative reports dictated by 693 surgeons across 517 facilities in 50 states were included. Median duration of follow-up was 4.6 years after initial surgery. Only 35.7% of operative reports were highly detailed. More recent operative reports, cases with resident involvement, and contaminated procedures were more likely to be highly detailed (all P < 0.05). Compared to poorly detailed operative reports, cases with highly detailed reports had fewer SSIs (13.2% vs 7.5%, P = 0.006), hernia recurrence (65.8% vs 55.4%, P = 0.002), and reoperation (78.9% vs 62.6%, P = 0.001).
UNASSIGNED: In this medico-legal dataset, most VHR operative reports are poorly detailed while highly detailed operative reports were associated with lower rates of complications. Future studies should examine a nationally representative dataset to validate our findings.
UNASSIGNED: VHR are one of the most common surgical procedures performed in the United States. Previous work has shown that VHR operative reports are poorly detailed, however, the relationship between operative report detail and patient outcomes is unknown.
UNASSIGNED: This is a retrospective cross-sectional observational study. Operative reports describing VHR were obtained from a medical-legal database. Medical records were screened and data was extracted including clinical outcomes, such as surgical site infection (SSI), hernia recurrence, and reoperation and the presence of key details in each report. Highly detailed operative reports were defined as having 70% of recommended details. The primary outcome was the prevalence of highly detailed VHR operative reports.
UNASSIGNED: A total of 1011 VHR operative reports dictated by 693 surgeons across 517 facilities in 50 states were included. Median duration of follow-up was 4.6 years after initial surgery. Only 35.7% of operative reports were highly detailed. More recent operative reports, cases with resident involvement, and contaminated procedures were more likely to be highly detailed (all P < 0.05). Compared to poorly detailed operative reports, cases with highly detailed reports had fewer SSIs (13.2% vs 7.5%, P = 0.006), hernia recurrence (65.8% vs 55.4%, P = 0.002), and reoperation (78.9% vs 62.6%, P = 0.001).
UNASSIGNED: In this medico-legal dataset, most VHR operative reports are poorly detailed while highly detailed operative reports were associated with lower rates of complications. Future studies should examine a nationally representative dataset to validate our findings.
摘要：
■我们的目的是在医学法律数据集中评估高度详细的腹疝修补（VHR）手术报告的患病率以及手术报告细节与术后结果之间的关联。
■VHR是美国最常见的外科手术之一。以前的工作表明，VHR手术报告不够详细，然而,手术报告细节与患者结局之间的关系未知.
■这是一项回顾性的横断面观察性研究。描述VHR的手术报告是从医学法律数据库中获得的。筛选医疗记录并提取数据，包括临床结果，如手术部位感染（SSI），疝气复发,和重新操作以及每个报告中的关键详细信息。高度详细的手术报告被定义为具有70%的推荐细节。主要结果是高度详细的VHR手术报告的患病率。
■共包括1011例VHR手术报告，由50个州的517个机构的693名外科医生指定。初始手术后的中位随访时间为4.6年。只有35.7%的手术报告非常详细。最近的行动报告，居民参与的案件，和污染的程序更可能是高度详细的（所有P<0.05）。与不详细的手术报告相比，报告非常详细的病例的SSIs较少(13.2%vs7.5%，P=0.006),疝复发（65.8%vs55.4%，P=0.002),和再次手术（78.9%对62.6%，P=0.001)。
■在这个医学法律数据集中，大多数VHR手术报告不详细,而高度详细的手术报告与较低的并发症发生率相关.未来的研究应该检查具有全国代表性的数据集来验证我们的发现。
■VHR是美国最常见的外科手术之一。以前的工作表明，VHR手术报告不够详细，然而,手术报告细节与患者结局之间的关系未知.
■这是一项回顾性的横断面观察性研究。描述VHR的手术报告是从医学法律数据库中获得的。筛选医疗记录并提取数据，包括临床结果，如手术部位感染（SSI），疝气复发,和重新操作以及每个报告中的关键详细信息。高度详细的手术报告被定义为具有70%的推荐细节。主要结果是高度详细的VHR手术报告的患病率。
■共包括1011例VHR手术报告，由50个州的517个机构的693名外科医生指定。初始手术后的中位随访时间为4.6年。只有35.7%的手术报告非常详细。最近的行动报告，居民参与的案件，和污染的程序更可能是高度详细的（所有P<0.05）。与不详细的手术报告相比，报告非常详细的病例的SSIs较少(13.2%vs7.5%，P=0.006),疝复发（65.8%vs55.4%，P=0.002),和再次手术（78.9%对62.6%，P=0.001)。
■在这个医学法律数据集中，大多数VHR手术报告不详细,而高度详细的手术报告与较低的并发症发生率相关.未来的研究应该检查具有全国代表性的数据集来验证我们的发现。
