Literature DB >> 19691949

Improving quality of care: development of a risk-adjusted perioperative morbidity model for vaginal hysterectomy.

Christine A Heisler1, Giovanni D Aletti, Amy L Weaver, L Joseph Melton, William A Cliby, John B Gebhart.   

Abstract

OBJECTIVE: We sought to develop and evaluate a risk-adjusted perioperative morbidity model for vaginal hysterectomy. STUDY
DESIGN: Medical records of women who underwent vaginal hysterectomy during 2004 and 2005 were retrospectively reviewed. Morbidity included hospital readmission, reoperation, and unplanned medical intervention or intensive care unit admission; urinary tract infections were excluded. Multivariate logistic regression identified factors associated with perioperative morbidity (adjusted for urinary tract infection). The resulting model was validated using a random 2006 sample.
RESULTS: Of 712 patients, 139 (19.5%) had morbidity associated with congestive heart failure or prior myocardial infarction, perioperative hemoglobin decrease >3.1 g/dL, preoperative hemoglobin <12.0 g/dL, and prior thrombosis (c-index = 0.68). Predicted morbidity was similar to observed rates in the validation sample.
CONCLUSION: History of congestive heart failure or myocardial infarction, prior thrombosis, perioperative hemoglobin decrease >3.1 g/dL, or preoperative hemoglobin <12.0 g/dL were associated with increased perioperative complications. Quality improvement efforts should modify these variables to optimize outcomes. Copyright 2010 Mosby, Inc. All rights reserved.

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Year:  2009        PMID: 19691949      PMCID: PMC2855620          DOI: 10.1016/j.ajog.2009.06.059

Source DB:  PubMed          Journal:  Am J Obstet Gynecol        ISSN: 0002-9378            Impact factor:   8.661


  7 in total

1.  Morbidity of 10 110 hysterectomies by type of approach.

Authors:  J Mäkinen; J Johansson; C Tomás; E Tomás; P K Heinonen; T Laatikainen; M Kauko; A M Heikkinen; J Sjöberg
Journal:  Hum Reprod       Date:  2001-07       Impact factor: 6.918

2.  Comparison of perioperative complications between reconstructive pelvic surgery and general gynecologic surgery.

Authors:  Sang Wook Bai; Jung Mi An; Jong Seung Shin; Joo Hyun Park; Sei Kwang Kim; Ki Hyun Park
Journal:  Yonsei Med J       Date:  2004-04-30       Impact factor: 2.759

3.  Use of national surgical quality improvement program data as a catalyst for quality improvement.

Authors:  Katherine S Rowell; Florence E Turrentine; Matthew M Hutter; Shukri F Khuri; William G Henderson
Journal:  J Am Coll Surg       Date:  2007-06       Impact factor: 6.113

Review 4.  Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors.

Authors:  F E Harrell; K L Lee; D B Mark
Journal:  Stat Med       Date:  1996-02-28       Impact factor: 2.373

5.  Prevalence of perioperative complications among women undergoing reconstructive pelvic surgery.

Authors:  N C Lambrou; J L Buller; J R Thompson; G W Cundiff; B Chou; F J Montz
Journal:  Am J Obstet Gynecol       Date:  2000-12       Impact factor: 8.661

Review 6.  Safety, quality, and the National Surgical Quality Improvement Program.

Authors:  Shukri F Khuri
Journal:  Am Surg       Date:  2006-11       Impact factor: 0.688

7.  A new frontier for quality of care in gynecologic oncology surgery: multi-institutional assessment of short-term outcomes for ovarian cancer using a risk-adjusted model.

Authors:  Giovanni D Aletti; Antonio Santillan; Eric L Eisenhauer; Jae Hu; Giacomo Aletti; Karl C Podratz; Robert E Bristow; Dennis S Chi; William A Cliby
Journal:  Gynecol Oncol       Date:  2007-06-28       Impact factor: 5.482

  7 in total
  4 in total

1.  Chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women.

Authors:  Heather F de Vries; Gina M Northington; Elise M Kaye; Hillary R Bogner
Journal:  Menopause       Date:  2011-12       Impact factor: 2.953

2.  Development of a Preoperative Clinical Risk Assessment Tool for Postoperative Complications After Hysterectomy.

Authors:  Payton C Schmidt; Neil S Kamdar; Elisabeth Erekson; Carolyn W Swenson; Shitanshu Uppal; Daniel M Morgan
Journal:  J Minim Invasive Gynecol       Date:  2021-10-20       Impact factor: 4.137

3.  Surgical site infection after hysterectomy.

Authors:  AeuMuro Gashaw Lake; Alexandra M McPencow; Madeline A Dick-Biascoechea; Deanna K Martin; Elisabeth A Erekson
Journal:  Am J Obstet Gynecol       Date:  2013-06-13       Impact factor: 8.661

4.  Major postoperative complications after benign gynecologic surgery: a clinical prediction tool.

Authors:  Elisabeth A Erekson; Sallis O Yip; Deanna K Martin; Maria M Ciarleglio; Kathleen A Connell; Terri R Fried
Journal:  Female Pelvic Med Reconstr Surg       Date:  2012 Sep-Oct       Impact factor: 2.091

  4 in total

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