Risk factors for potentially avoidable readmissions following gynecologic oncology surgery

2020 ◽  
Vol 159 (1) ◽  
pp. 195-200
Author(s):  
A. Pyrzak ◽  
A. Saiz ◽  
R.M. Polan ◽  
E.L. Barber
Keyword(s):  
Risk Factors ◽  
Gynecologic Oncology ◽  
Avoidable Readmissions

Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country

2017 ◽  
Vol 5 (1) ◽  
pp. 23-27
Author(s):  
Erum S Khan ◽  
Sheikh Irfan ◽  
Natasha Khalid
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Cancer Patients ◽  
Developing Country ◽  
Gynecologic Oncology ◽  
Tertiary Care ◽  
Gynecologic Cancer ◽  
Care Facility ◽  
Site Infection ◽  
Tertiary Care Facility

ABSTRACT Introduction Surgical site infections (SSIs) are among the most common complications in surgical patients and have serious consequences for outcomes and costs. There is a dearth of information on risk factors for developing SSI in patients undergoing gynecologic cancer surgery, and this has not been studied using national data. Objectives The objectives of this study were to estimate the prevalence, preoperative and operative risk factors associated with the higher risk of SSIs in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Setting Department of Obstetrics and Gynaecology, Aga Khan University Hospitals, Karachi, Sindh, Pakistan. Materials and methods Retrospective record review of gynecologic oncology patients admitted for surgery from January 2015 to December 2015 was performed. Results A total of 100 patients met the inclusion criteria. Of these, 15 were identified with SSIs, which were all found to be of the superficial type. Approximately, 44, 40, and 7% were diagnosed with endometrial, ovarian, and cervical cancers respectively. The mean time from surgery to developing SSI was 12.9 days. Among endometrial cancer, 22.7% (10/44) had SSI compared with 7.5% (3/40) for ovarian cancer and 14.2% (1/7) for cervical cancer. The significant predictors of SSI were body mass index ≥35 (p-value <0.004), endometrial cancer diagnosis, the American Society of Anesthesiologists class more than 3, modified surgical complexity scoring system 3 to 4, and blood sugar levels more than 180 mg/dL within 48 hours after surgery in known diabetics. Conclusion About 15% of patients undergoing laparotomy for gynecologic malignancy developed SSIs. In this study, we identified several risk factors for developing SSI among gynecologic cancer patients. These findings may contribute toward identification of patients at risk for SSIs, and the development of strategies to reduce SSI rate and potentially reduce the cost of care in gynecologic cancer surgery. How to cite this article Khan ES, Irfan S, Khalid N. Rate and Risk Factors for Surgical Site Infection in Gynecologic Oncology Surgeries at a Tertiary Care Facility in a Developing Country. J South Asian Feder Menopause Soc 2017;5(1):23-27.

scholarly journals Unplanned 30-day readmission rates as a quality measure: Risk factors and costs of readmission to a gynecologic oncology service

2016 ◽  
Vol 141 ◽  
pp. 14
Author(s):  
M.B. Wilbur ◽  
D.B. Mannschreck ◽  
E.J. Tanner ◽  
B. Stone ◽  
K. Levinson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gynecologic Oncology ◽  
Quality Measure ◽  
Readmission Rates ◽  
Oncology Service

Risk Factors, Morbidity, and Quality of Life Associated with Same-Day Discharge in Gynecologic Oncology

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Fabrice Narducci ◽  
Emilie Bogart ◽  
Sophie Paget-Bailly ◽  
Ralph Saadeh ◽  
Marie-Cécile Le Deley ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Gynecologic Oncology ◽  
Same Day Discharge

Myocardial injury after gynecologic oncology surgery in septuagenarians and octogenarians: Is there a role for routine postoperative cardiac biomarker monitoring?

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 220-220
Author(s):  
Tharani Anpalagan ◽  
Kathy Huang ◽  
Maura Marcucci ◽  
Sarah Mah ◽  
Millie Walker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Injury ◽  
Angiotensin Receptor Blockers ◽  
Frailty Index ◽  
Gynecologic Oncology ◽  
Univariate Analysis ◽  
Multivariable Analysis ◽  
Cardiac Risk ◽  
Improvement Program ◽  
Surgical Complexity

220 Background: Accumulating evidence correlates myocardial injury after noncardiac surgery (MINS), even when asymptomatic, with increased cardiac and non-cardiac morbidity and mortality. There is no literature on MINS specific to Gynecologic Oncology. We sought to evaluate the incidence and risk factors of MINS in patients aged ≥70. Methods: Elective laparotomies between 01/2016-09/2020 for patients aged≥70 at a tertiary hospital in ON, Canada, were reviewed using prospectively-collected National Surgical Quality Improvement Program (NSQIP) data. MINS was defined as peak serum high-sensitivity troponin-T concentration ≥0.04ng/mL within 30 days postoperatively. Logistic regression analysis was performed. Results: In this cohort of 258 patients, of 242 (93.8%) who underwent postoperative troponin screening, 40 (16.5%) experienced MINS without exhibiting ischemic symptoms or ECG changes. The diagnosis of MINS led to a prescription or optimization of cardiovascular medications for 35 patients (87.5%). On univariate analysis, Revised Cardiac Risk Index (RCRI) of 3-5(p = 0.002), history of coronary artery disease (p = 0.003) or insulin-dependent diabetes (p = 0.006), preoperative use of antiplatelets (p = 0.009), beta-blockers (p = 0.02), ACE-inhibitors (ACEI) or angiotensin-receptor blockers (ARB)(p = 0.002) and frailty as defined by the NSQIP modified frailty index-5 (p = 0.02), were associated with greater risk of MINS. Factors reflecting surgical complexity including surgical complexity score, operative duration, blood loss and advanced oncologic stage were not predictive. Multivariable analysis using backward selection procedure identified elevated RCRI and preoperative ACE/ARB as significant risk factors (OR 5.93, 95% CI 1.52-24.31, p = 0.01 and OR 2.4, 95% CI 1.18-5.06, p = 0.02). Conclusions: One in 6 patients in our cohort experienced asymptomatic MINS irrespective of surgical complexity. Our analysis highlights a possible opportunity to optimize cardiac risk factors and to potentially improve perioperative patient safety by reducing morbidity. Routine preoperative cardiac risk-stratification and postoperative cardiac biomarkers monitoring should be considered in elderly patients with gynecologic malignancies.[Table: see text]

The Risk Factors of Readmission in Postoperative Gynecologic Oncology Patients at a Single Institution

2015 ◽  
Vol 25 (9) ◽  
pp. 1697-1703 ◽  
Author(s):  
John M. Nakayama ◽  
Jennie P. Ou ◽  
Caroline Friedman ◽  
Mark E. Smolkin ◽  
Linda R. Duska
Keyword(s):  
Risk Factors ◽  
Quality Care ◽  
Operative Procedure ◽  
Gynecologic Oncology ◽  
Time Frame ◽  
Psychiatric Disease ◽  
Cancer History ◽  
Oncology Service ◽  
Hospital Readmission Rates ◽  
Surgical Modality

IntroductionHospital readmission rates are an important measure of quality care and have recently been tied to reimbursement. This study seeks to identify the risk factors for postoperative readmission in patients treated by a gynecologic oncology service.MethodsA 7-year retrospective review (2007–2013) of all patients operated on by the University of Virginia gynecologic oncology service who were readmitted within 30 days of discharge was performed. Abstracted data included demographics, dates of surgery, operative details, cancer history, and relevant medical history. The readmitted patients (n = 166) were compared with randomly selected controls (n = 168) from the same service in a matching time frame and analyzed using univariate and multivariate models.ResultsIn the study period, 2993 operations were performed. One hundred sixty-six unique patients (5.5%) were readmitted within 30 days of discharge from their operative procedure. On multivariate analysis, the factors that were associated with a higher risk of readmission were a history of psychiatric disease, postoperative complication, type of insurance, surgical modality, and lysis of adhesions at the time of surgery. The most common readmission diagnoses were infection (44%), nausea/vomiting (28%), thrombosis (6%), bowel leak (4%), and bleeding (4%).ConclusionsPostoperative readmissions are a common problem and are increasingly important as a measure of quality. Although patients were generally admitted for infections or gastrointestinal complaints, we also found that individual factors such as mental health and socioeconomic status also contributed. Our data suggest that we can preoperatively identify high-risk individuals for whom extra resources can be directed postoperatively to avoid unnecessary readmissions.

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