Patient complaints in the postoperative period following spine surgery

2021 ◽  
pp. 1-8
Author(s):  
Andrew A. Ronald ◽  
Vineeth Sadda ◽  
Nicholas M. Rabah ◽  
Michael P. Steinmetz
Keyword(s):  
Quality Of Care ◽  
Postoperative Complications ◽  
Spine Surgery ◽  
Postoperative Period ◽  
Study Patient ◽  
Control Group ◽  
Communication Breakdown ◽  
Patient Complaints ◽  
Postoperative Complaints

OBJECTIVE Patient complaints are associated with a number of surgical and medical outcomes. Despite high rates of patient complaints regarding spine surgeons and efforts to study patient complaints across medicine and surgery, few studies have analyzed the complaints of patients undergoing spinal surgery. The authors present a retrospective analysis that, to their knowledge, is the first study to directly investigate the complaints of spine surgery patients in the postoperative period. METHODS Institutional records were reviewed over a 5-year period (2015–2019) to identify patients who underwent spine surgery and submitted a complaint to the institution’s ombudsman’s office within 1 year of their surgery. A control group, comprising patients who underwent spine surgery without filing a complaint, was matched to the group that filed complaints by admission diagnosis and procedure codes through propensity score matching. Patient demographic and clinical data were obtained by medical record review and compared between the two groups. Patient complaints were reviewed and categorized using a previously established taxonomy. RESULTS A total of 52 patients were identified who submitted a complaint after their spine surgery. There were 56 total complaints identified (4 patients submitted 2 each) that reported on 82 specific issues. Patient complaints were most often related to the quality of care received and communication breakdown between the healthcare team and the patient. Patients who submitted complaints were more likely to be Black or African American, have worse baseline health status, and have had prior spine surgery. After their surgery, these patients were also more likely to have longer hospital stays, experience postoperative complications, and require reoperation. CONCLUSIONS Complaints were most often related to the quality of care received and communication breakdown. A number of patient-level demographic and clinical characteristics were associated with an increased likelihood of a complaint being filed after spine surgery, and patients who filed complaints were more likely to experience postoperative complications. Improving communication with patients could play a key role in working to address and reduce postoperative complaints. Further study is needed to better understand patient complaints after spine surgery and investigate ways to optimize the care of patients with risks for postoperative complaints.

scholarly journals Impact of Diabetes Mellitus on Cervical Spine Surgery for Ossification of the Posterior Longitudinal Ligament

2021 ◽  
Vol 10 (15) ◽  
pp. 3375
Author(s):  
Atsushi Kimura ◽  
Katsushi Takeshita ◽  
Toshitaka Yoshii ◽  
Satoru Egawa ◽  
Takashi Hirai ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cervical Spine ◽  
Postoperative Complications ◽  
Spine Surgery ◽  
Posterior Longitudinal Ligament ◽  
Lower Extremity Function ◽  
Cervical Spine Surgery ◽  
The Impact

Ossification of the posterior longitudinal ligament (OPLL) is commonly associated with diabetes mellitus (DM); however, the impact of DM on cervical spine surgery for OPLL remains unclear. This study was performed to evaluate the influence of diabetes DM on the outcomes following cervical spine surgery for OPLL. In total, 478 patients with cervical OPLL who underwent surgical treatment were prospectively recruited from April 2015 to July 2017. Functional measurements were conducted at baseline and at 6 months, 1 year, and 2 years after surgery using JOA and JOACMEQ scores. The incidence of postoperative complications was categorized into early (≤30 days) and late (>30 days), depending on the time from surgery. From the initial group of 478 patients, 402 completed the 2-year follow-up and were included in the analysis. Of the 402 patients, 127 (32%) had DM as a comorbid disease. The overall incidence of postoperative complications was significantly higher in patients with DM than in patients without DM in both the early and late postoperative periods. The patients with DM had a significantly lower JOA score and JOACMEQ scores in the domains of lower extremity function and quality of life than those without DM at the 2-year follow-up.

scholarly journals Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037708
Author(s):  
Ira Helena Saarinen ◽  
Jaana-Maija Koivisto ◽  
Antti Kaipia ◽  
Elina Haavisto
Keyword(s):  
Quality Of Care ◽  
Postoperative Complications ◽  
Cross Sectional Study ◽  
Perceived Quality ◽  
Living Alone ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Perceived Quality Of Care

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.

Improving the efficiency of the postoperative period in the surgical treatment cancer patients with metastatic bone fractures upper and lower extremities using elixir altai ("vitavis") in combination with ion-activated water resources

10.12737/6454 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Антонов ◽  
A. Antonov
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Cancer Patients ◽  
Postoperative Period ◽  
Bone Fractures ◽  
Infectious Complications ◽  
Lower Limbs ◽  
Oncologic Patients

Use elixir Altai ("Vitavis") in combination with ion-activated with water by means of such a complex contingent cancer patients as patients with metastatic bone fractures of the upper and lower limbs can reduce the early postoperative period, and to reduce to a minimum infectious complications and improve quality of life. The problem of postoperative complications, until now, is not solved. In oncologic patients, and those more in by III and As IV stages occurs it immunnodefitsit, which is caused not only by basic disease, but also by conse-quences of khimio- beam therapy. In connection with this appears the difficulty in the surgical treatment, caused by postoperative complications. As a result surgical treatment appears surgical injury, oxidizing stress, disturbance of homeostasis and oppression of immunity, which leads to an even larger disturbance of immunity in oncologic patients, which decreases the unspecific resistibility of organism. The application of adaptogena of the elixir of Altai (“Vitavis”) in combination with the ionic- activated aqueous means makes it possible to level and to reduce on no oxidizing stress, to increase the unspecific resistibility of the organism of oncologic patient and to increase immuni-ty. Moreover, powerful antioxidant - the ionic- activated aqueous means strengthens the action of adaptogena of the elixer of Altai (“Vitavis”), which leads to the decrease of postoperative infectious complications, reduces postoperative period, improves the quality of life and enlarges indications to the surgical treatment in oncologic patients with III it and IV by the stages of diseases.

scholarly journals Analysis of the Effect of Cluster Nursing in Postoperative Hypertensive Cerebral Hemorrhage

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Pingxia Zheng ◽  
Jia Wang ◽  
Yan Ma ◽  
Jingjing Xu ◽  
Qianping Zhu
Keyword(s):  
Postoperative Complications ◽  
Intracerebral Hemorrhage ◽  
Treatment Compliance ◽  
Nursing Intervention ◽  
Control Group ◽  
Total Incidence ◽  
Hypertensive Intracerebral Hemorrhage ◽  
And Control ◽  
Experimental Group

Hypertensive intracerebral hemorrhage is a common condition in clinic. Due to the improvement of minimally invasive technology, its therapeutic effect is good, but there are still postoperative complications. The corresponding routine nursing intervention is not effective in the rehabilitation of postoperative patients with hypertensive intracerebral hemorrhage. In this paper, cluster nursing was applied to the treatment of postoperative patients with hypertensive intracerebral hemorrhage. For this purpose, a retrospective study or experiment was conducted on 150 patients with hypertensive intracerebral hemorrhage in the hospital specifically from January 2019 to December 2020. According to the nursing strategy, patients were divided into experimental (n = 75) and control groups (n = 75), respectively. The control group adopted routine nursing mode, whereas the experimental group adopted cluster nursing mode. The treatment compliance of patients in the experimental group was 86.67%, while that in the control group was 73.33% ( P  < 0.05). The total incidence of postoperative complications in the experimental group was 3.2%, which was lower than 25% in the control group ( P  < 0.05). The motor function score of the experimental group was better than that of the control group ( P  < 0.05). The application of cluster nursing in postoperative patients with hypertensive intracerebral hemorrhage is feasible, and its nursing effect is significant, which can not only reduce the incidence of postoperative complications but also improve patients’ compliance and quality of life. It has good application value.

scholarly journals Immediate and long-term results of laparoscopic hernioplasty in inguinal hernias with and without mesh endoprosthesis fixation

2020 ◽  
Vol 179 (4) ◽  
pp. 22-28
Author(s):  
O. V. Zaitsev ◽  
A. V. Koshkina ◽  
D. A. Khubezov ◽  
V. A. Yudin ◽  
V. V. Barsukov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Mesh Fixation ◽  
Long Term Results ◽  
Control Group ◽  
Inguinal Hernioplasty ◽  
Inguinal Hernias ◽  
Laparoscopic Hernioplasty ◽  
Mesh Endoprosthesis

The objective of this study was to conduct comparative analysis of the immediate and long-term results of laparoscopic inguinal hernioplasty performed with and without fixation of the mesh endoprosthesis.Methods and materials. The base group included 77 patients who underwent laparoscopic inguinal hernioplasty without fixation of the mesh by herniostepler. The control group included 76 patients who underwent laparoscopic inguinal hernioplasty with mesh fixation by herniostepler. To assess the postoperative period, the following criteria were studied: the severity of postoperative pain on a Visual Analog Scale; postoperative complications on the Clavien-Dindo scale; an early recurrence of inguinal hernias determined by ultrasound.Results. In both groups, the severity of postoperative complications did not exceed grade I. Among the entire list of complications, there were observed: pain in the area of surgery, an increase in body temperature above 38.5 °C, acute urinary retention, swelling and hematoma of the scrotum, seroma. There were no cases of conversion, intraoperative damage to internal organs and vascular structures. Complications in both groups do not differ significantly and do not depend on the method of laparoscopic inguinal hernioplasty: with fixation of the endoprosthesis by herniostepler or without fixation. The level of pain in the early postoperative period in patients operated by laparoscopic inguinal hernioplasty with mesh fixation was significantly higher. During control examinations of patients on the day after surgery, at the time of discharge and 6 months after surgery, no cases of dislocation of mesh endoprosthesis and relapse of inguinal hernia were detected.Conclusion. The obtained data indicate the effectiveness of laparoscopic hernioplasty in inguinal hernias with polypropylene mesh without fixing with herniostepler.

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals Quality of Care Perceived by Older Patients and Caregivers in Integrated Care Pathways With Interviewing Assistance From a Social Robot: Noninferiority Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Roel Boumans ◽  
Fokke van Meulen ◽  
William van Aalst ◽  
Joyce Albers ◽  
Marèse Janssen ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Older Patients ◽  
Care Pathway ◽  
Controlled Trial ◽  
Social Robot ◽  
Control Group ◽  
Robot Assisted ◽  
Significant Difference

BACKGROUND Society is facing a global shortage of 17 million health care workers, along with increasing health care demands from a growing number of older adults. Social robots are being considered as solutions to part of this problem. OBJECTIVE Our objective is to evaluate the quality of care perceived by patients and caregivers for an integrated care pathway in an outpatient clinic using a social robot for patient-reported outcome measure (PROM) interviews versus the currently used professional interviews. METHODS A multicenter, two-parallel-group, nonblinded, randomized controlled trial was used to test for noninferiority of the quality of care delivered through robot-assisted care. The randomization was performed using a computer-generated table. The setting consisted of two outpatient clinics, and the study took place from July to December 2019. Of 419 patients who visited the participating outpatient clinics, 110 older patients met the criteria for recruitment. Inclusion criteria were the ability to speak and read Dutch and being assisted by a participating health care professional. Exclusion criteria were serious hearing or vision problems, serious cognitive problems, and paranoia or similar psychiatric problems. The intervention consisted of a social robot conducting a 36-item PROM. As the main outcome measure, the customized Consumer Quality Index (CQI) was used, as reported by patients and caregivers for the outpatient pathway of care. RESULTS In total, 75 intermediately frail older patients were included in the study, randomly assigned to the intervention and control groups, and processed: 36 female (48%) and 39 male (52%); mean age 77.4 years (SD 7.3), range 60-91 years. There was no significant difference in the total patient CQI scores between the patients included in the robot-assisted care pathway (mean 9.27, SD 0.65, n=37) and those in the control group (mean 9.00, SD 0.70, n=38): <i>P</i>=.08, 95% CI –0.04 to 0.58. There was no significant difference in the total CQI scores between caregivers in the intervention group (mean 9.21, SD 0.76, n=30) and those in the control group (mean 9.09, SD 0.60, n=35): <i>P</i>=.47, 95% CI –0.21 to 0.46. No harm or unintended effects occurred. CONCLUSIONS Geriatric patients and their informal caregivers valued robot-assisted and nonrobot-assisted care pathways equally. CLINICALTRIAL ClinicalTrials.gov NCT03857789; https://clinicaltrials.gov/ct2/show/NCT03857789

scholarly journals CHANGE IN THE QUALITY OF LIFE OF CHILDREN AFTER SURGICAL TREATMENT OF RETINAL DETACHMENT

2018 ◽  
Vol 25 (6) ◽  
pp. 149-153
Author(s):  
A. N. Sergienko ◽  
V. V. Dashina ◽  
A. V. Malyshev ◽  
O. I. Lysenko ◽  
S. V. Yanchenko
Keyword(s):  
Quality Of Life ◽  
Statistical Analysis ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Control Group ◽  
Russian Version ◽  
Group I ◽  
Group Ii

Aim.The study was designed for the evaluation of the quality of life of children with retinal detachment during vitrectomy.Materials and methods. 23 children with retinal detachment aged from 10 to 17 years were treated. Surgical treatment consisted of a three-port vitrectomy and a laser endocoagulation of the retina. 3 groups were formed with the help of a random sampling. During the surgical treatment of group I (n=8), only balanced non-oxidant solutions of salts (Balsed Salt Solution − BSS) were used. Tablets of antioxidant preparations were not assigned. Saline solutions with antioxidants (BSS plus) were used to carry out surgery for group II (n=8). Group III (n=7) was additionally taking antioxidant preparations peros for 3 months in the postoperative period . The quality of life was studied using the abridged Russian version of the VFQ-25 questionnaire. 10 children of the same age with no indications of surgical treatment of retinal detachment were selected for the control group. Statistical analysis of the obtained data was carried out using a set of programs for applied statistical analysis Analyst Soft, Bio Stat 2007.Results.A week after the surgical treatment, no increase in visometric data was observed. Six months later, a significant increase in visual acuity was revealed. The highest visometric data were observed in group II due to the minimal progression of lens opacities. Group I patients had the lowest values of this index.Conclusion.The positive effect of the surgical treatment of retinal detachment positively influenced the patients’ quality of life in the early and late postoperative period.

scholarly journals Quality of life changes after surgical treatment of retinal detachment

2014 ◽  
Vol 7 (2) ◽  
pp. 23-29
Author(s):  
Z Zh Al-Rashid ◽  
Aleksey Vladislavovich Malyshev ◽  
Ol’ga Igorevna Lysenko
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Retinal Detachment ◽  
Postoperative Period ◽  
Visual Function ◽  
Progressive Increase ◽  
Control Group ◽  
Life Changes ◽  
Late Postoperative Period

Purpose. To study the effect of vitrectomy in retinal detachment (RD) treatment on the quality of life (QOL) of patients. Methods. We examined 67 patients who underwent surgical treatment of RD. QOL was assessed by VFQ-25 questionnaire before surgery and after 1 week and 6 months of it. Results. When assessing QOL before surgery, there was a significant reduction of the total QOL index by an average of 35% in comparison to the control group (p < 0.001). In the late postoperative period, a progressive increase of the total QOL index and visual function was recorded. Conclusion. Vitrectomy for the treatment of retinal detachment improves patients’ visual function and quality of life.

scholarly journals THE DEPENDENCE OF DIRECT RESULTS OF DISTAL PANCREATECTOMIES ON DIFFERENT PANCREATIC STUMP CLOSURE TECHNIQUES

2018 ◽  
Vol 177 (4) ◽  
pp. 23-27
Author(s):  
S. E. Voskanyan ◽  
E. V. Naydenov ◽  
I. Yu. Uteshev ◽  
A. I. Artemiev ◽  
Yu. D. Udalov ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Pancreatic Duct ◽  
Postoperative Period ◽  
Main Pancreatic Duct ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Pancreatic Stump ◽  
Stump Closure ◽  
Pancreatic Fistulas

The  OBJECTIVE  is  to  study  the  effect  of application of different  pancreatic stump  closure techniques to  the  postoperative period,  the frequency and  severity  of postoperative complications including postoperative pancreatic fistulas  after distal pancreatectomies. MATERIAL AND METHODS.  The  clinical  material  consisted of 126  patients who  underwent distal  pancreatectomies  (isolated or  in  combination  with  surgical   interventions  on  the  adjacent organs of  the  abdominal cavity  and retroperitoneal space).  The  patients  were   divided  into  4  groups  depending  on  the  pancreatic  stump   closure  techniques (isolated suturing  of the  main  pancreatic duct  of the  pancreatic stump  with its omentization by gastrocolic omentum or local sealing its  by  hemostatic sponge  (control  group);  using  a  local  biological  glue  2-octylcyanoacrylate; using  the  Endoscopic Linear  Cutter  Echelon; external transduodenal  transnasal  drainage of the  enlarged main  pancreatic duct  of the  pancreatic stump). We  evaluated the  influence   of  different  pancreatic stump   closure techniques  after  distal  pancreatectomies on  the postoperative period  as well the  frequency and  severity  of postoperative pancreatic fistulas  depending on the  diameter of the main  pancreatic duct  of pancreatic stump.   RESULTS.  The  overall  rate  of postoperative  complications in the  control  group of patients was  45.8  %, and  was  due  to an  increase in the  frequency of specific  complications (35.4  %). The  most  frequent complication  in  the  control  group   of  patients  was   postoperative  pancreatic  fistulas   –  29.2   %.  The  statistically   significant decrease  of  frequency  and   severity   of  postoperative  complications,  frequency  and   severity   of  postoperative  pancreatic fistulas and decrease of postoperative hospital-stay after the application of the proposed different pancreatic stump closure techniques were  revealed in comparison with the  control  group  of patients. There  was  no  hospital  mortality.  CONCLUSION. Distal  pancreatectomy with  «standard»  pancreatic stump   closure techniques  accompanied by  high  frequency and  severity of postoperative complications, as well as postoperative pancreatic fistulas. The use of the proposed pancreatic stump closure techniques after  distal  pancreatectomy led  to  a  decrease of  the  frequency and  severity   of  postoperative  complications, a decrease of the  frequency and  severity  of postoperative pancreatic fistulas,  and  a decrease of the  postoperative hospital-stay.

Sign in / Sign up

Export Citation Format

Share Document