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AlDardeir N, Alzhrani G, Alqutub A, Kabli R, Sait D, Alsaeed R, Alruwaithi S, Algarni A, Sawan D. Rates and Causes of Readmission Within 60 Days Following Hysterectomy in a Tertiary Care Center in Saudi Arabia. Cureus 2023; 15:e36500. [PMID: 37090381 PMCID: PMC10121272 DOI: 10.7759/cureus.36500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
INTRODUCTION Unplanned readmissions are frequent, costly, and perhaps avoidable. We aim to identify the rate, causes, and predictive factors of hospital readmission after hysterectomy within 60 days post-discharge at King Abdulaziz University Hospital (KAUH). METHODS Retrospective record review of all patients who underwent hysterectomy for benign and malignant conditions from January 2017 to December 2022. Patients were evaluated for demographics, comorbidities, and causes for readmission. RESULTS Of 117 patients, the unplanned readmission rate was 9.4% and 7.7% for benign and malignant conditions, respectively. Infections (25%) and abdominal pain (20%) were common causes. Patients with increased intraoperative bleeding (P = 0.013) and cancer patients (0.044) had an increased risk for readmission. Readmitted patients had significantly higher baseline health burdens when compared to non-readmitted patients using the American Society of Anesthesiology scores (ASA) (p = 0.011) and the Cumulative Illness Rating Scale (CIRS) (p = 0.004). CONCLUSION The 60-day readmission rate after a hysterectomy was 17.1%. Infections and abdominal pain represented common causes. Malignancy and increased intraoperative blood loss are significant risk factors. In order to decrease the readmission rate, addressing common reasons may be beneficial.
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Affiliation(s)
- Nashwa AlDardeir
- Department of Obstetrics and Gynecology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ghadi Alzhrani
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Abdulsalam Alqutub
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Raghad Kabli
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Deyala Sait
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Refan Alsaeed
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Shahad Alruwaithi
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Areej Algarni
- Department of Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Dana Sawan
- Department of Obstetrics and Gynecology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
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Unbeck M, Lindemalm S, Nydert P, Ygge BM, Nylén U, Berglund C, Härenstam KP. Validation of triggers and development of a pediatric trigger tool to identify adverse events. BMC Health Serv Res 2014; 14:655. [PMID: 25527905 PMCID: PMC4300839 DOI: 10.1186/s12913-014-0655-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 12/11/2014] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Little is known about adverse events (AEs) in pediatric patients. Record review is a common methodology for identifying AEs, but in pediatrics the record review tools generally have limited focus. The aim of the present study was to develop a broadly applicable record review tool to identify AEs in pediatric inpatients. METHODS Using a broad literature review and expert opinion with a modified Delphi process, a pediatric trigger tool with 88 triggers, definitions, and descriptions including AE preventability decision support was developed and tested in a random sample of 600 hospitalized pediatric patients admitted in 2010 to a single university children's hospital. Four registered nurse-physician teams performed complete two-stage retrospective reviews of 150 records each from either neonatal, surgical/orthopedic, medicine, or emergency medicine units. RESULTS Registered nurse review identified 296 of 600 records with triggers indicating potential AEs. Records (n = 121) with only false positive triggers not indicating any potential AEs were not forwarded to the next review stage. On subsequent physician review, 204 (34.0%) of patients were found to have had 563 AEs, range 1-27 AEs/patient. A total of 442 preventable AEs were found in 161 patients (26.8%), range 1-22. Overall, triggers were found 3,598 times in 417 (69.5%) records, with a mean of 6 (median 1, range 0-176) triggers per patient. The overall positive predictive value of the triggers was 22.9%, (range 0.0-100.0%). The final pediatric trigger tool, developed with a second Delphi round, required 29 triggers. CONCLUSIONS AEs are common in pediatric patients and most are preventable. The main contributions of this study are to further develop and adapt trigger definitions, including AE preventability decision support, to introduce new triggers in pediatric care, as well as to apply pediatric triggers in different clinical specialties. Our findings resulted in a national pediatric trigger tool, and might also be adapted internationally. The pediatric trigger tool can help healthcare organizations to measure and analyze the AEs occurring in hospitalized children in order to improve patient safety.
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Affiliation(s)
- Maria Unbeck
- Department of Orthopedics, Danderyd Hospital, 182 88, Stockholm, Sweden.
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, 182 88, Stockholm, Sweden.
| | - Synnöve Lindemalm
- Division of Pediatrics, Astrid Lindgren's Children's Hospital, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Per Nydert
- Division of Pediatrics, Astrid Lindgren's Children's Hospital, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Britt-Marie Ygge
- Division of Pediatrics, Astrid Lindgren's Children's Hospital, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- Department of Women's and Children's Health, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Urban Nylén
- Unit for Quality and Patient Safety, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- SALAR (Swedish Association of Local Authorities and Regions), 118 82, Stockholm, Sweden.
| | - Carina Berglund
- Unit for Quality and Patient Safety, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- SALAR (Swedish Association of Local Authorities and Regions), 118 82, Stockholm, Sweden.
| | - Karin Pukk Härenstam
- Division of Pediatrics, Astrid Lindgren's Children's Hospital, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- Medical Management Centre, Karolinska Institutet, 171 77, Stockholm, Sweden.
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