Risk-adjusted rates for potentially avoidable reoperations were computed from routine hospital data.

TitreRisk-adjusted rates for potentially avoidable reoperations were computed from routine hospital data.
Publication TypeJournal Article
Year of Publication2007
AuthorsHalfon, P, Eggli, Y, Matter, M, Kallay, C, van Melle, G, Burnand, B
JournalJ Clin Epidemiol
Date Published2007 Jan
Mots-clésAdult, Aged, Algorithms, Female, Health Services Research, Hospitals, Humans, Male, Medical Errors, Medical Records, Middle Aged, Postoperative Complications, Prognosis, Quality Indicators, Health Care, Reoperation, Risk Factors, Surgical Procedures, Operative, Switzerland

OBJECTIVES: Reoperations may reflect a suboptimal initial surgical treatment. The study aimed to develop a screening algorithm for those potentially avoidable, using only routinely collected hospital data and a prediction model to adjust rates for case-mix.

STUDY DESIGN AND SETTING: Data of a 3-year random sample of 7,370 therapeutic operations on inpatients, among which 833 were followed-up by a reoperation during the same stay. A review of medical records identified clearly avoidable and other potentially avoidable reoperations to develop and test the screening algorithm. A logistic prediction model of potentially avoidable reoperations was developed on one randomly chosen half of the data (about 9,000 interventions) and tested on the other half (cross-validation).

RESULTS: Two hundred thirty-seven interventions (3%) were followed by a potentially avoidable reoperation, among which 144 were clearly avoidable. The screening algorithm had a sensitivity of 75% and a specificity of 72%. Predictors of potentially avoidable reoperations were surgery categories, diagnosis related conditions, and experiencing prior surgery. The risk score, based on these variables, showed at once a satisfactory discriminative performance (C-statistic=0.76) and goodness-of-fit measure on the validation set.

CONCLUSION: The adjusted rate of potentially avoidable reoperations should be included in internal reporting of hospital quality indicators, but further validated in various settings.

Alternate URL


Alternate JournalJ Clin Epidemiol
Citation Key / SERVAL ID2463
PubMed ID17161755

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