PDF(Pubmed)
Abstract：
The aim of this study is to evaluate the accuracy of outcome reporting after elective visceral surgery in a low volume district hospital. Outcome measurement as well as transparent reporting of surgical complications becomes more and more important. In the future, financial and personal resources may be distributed due to reported quality and thus, it is in the main interest of healthcare providers that outcome data are accurately collected. Between 10/2020 and 09/2021 postoperative complications during the hospitalisation were recorded using the Clavien-Dindo classification (CDC) and comprehensive complication index by residents of a surgical department in a district hospital. After one year of prospective data collection, data were retrospectively analyzed and re-evaluated for accuracy by senior consultant surgeons. In 575 patients undergoing elective general or visceral surgery interns and residents reported an overall rate of patients with complications of 7.3% (n = 42) during the hospitalization phase, whereas a rate of 18.3% (n = 105) was revealed after retrospective analysis by senior consultant surgeons. Thus, residents failed to report patients with postoperative complications in 60% of cases (63/105). In the 42 cases, in which complications were initially reported, the grading of complications was correct only in 33.3% of cases (n = 14). Complication grades that were most missed were CDC grade I and II. Quality of outcome measurement in a district hospital is poor if done by unexperienced residents and significantly underestimates the true complication rate. Outcome measurement must be done or supervised by experienced surgeons to ensure correct and reliable outcome data.
摘要：
这项研究的目的是评估在低容量地区医院进行内脏手术后结果报告的准确性。结果测量以及手术并发症的透明报告变得越来越重要。在未来,由于报告的质量，财务和个人资源可能会被分配，因此，准确收集结果数据符合医疗保健提供者的主要利益。在2020年10月至2021年9月期间，使用Clavien-Dindo分类（CDC）和综合并发症指数记录了住院期间的术后并发症。经过一年的前瞻性数据收集，由高级顾问外科医生对数据进行回顾性分析并重新评估准确性.在575名接受择期普通或内脏手术实习生和住院医师的患者中，住院期间并发症的总发生率为7.3％（n=42）。而经过高级顾问外科医生的回顾性分析后发现的比率为18.3％（n=105）。因此，在60%的病例(63/105)中,住院医师未能报告患者术后并发症.在42个案例中，最初报告的并发症，并发症分级仅在33.3%的病例中正确(n=14).最容易错过的并发症等级是CDCI级和II级。如果由缺乏经验的居民进行，则地区医院的结果测量质量较差，并且严重低估了真实的并发症发生率。结果测量必须由经验丰富的外科医生进行或监督，以确保结果数据正确可靠。
