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Rescue Surgery and Failure to Rescue

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The High-risk Surgical Patient
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Abstract

Emergency surgery contributes to half of surgical mortality and is associated with a 50% complication and 15% readmission rate. Delay to surgical intervention is associated with a considerable increase in mortality and postoperative complications. The results of the management of severe complications reflect the quality of care in different hospitals and there is great variety in failure to rescue rates between hospitals. Many factors contribute to low failure to rescue rates. Hospital volume and especially the experience of the emergency surgeon have a major impact on the outcomes.

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References

  1. http://www.cdc.gov/nchs/data

  2. Sartelli M, Chichom-Mefire A, Labricciosa FM, et al. The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2017;12:29. https://doi.org/10.1186/s13017-017-0141-6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Tolonen M, Sallinen V, Mentula P, et al. Preoperative prognostic factors for severe diffuse secondary peritonitis: a retrospective study. Langenbeck’s Arch Surg. 2016;401:611–7.

    Article  Google Scholar 

  4. Clavien PA, Sanabria JR, Strasberg SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery. 1992;111:518–26.

    CAS  PubMed  Google Scholar 

  5. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–96.

    Article  PubMed  Google Scholar 

  7. Slankamenac K, Graf R, Barkun J, et al. The comprehensive complication index. A novel continuous scale to measure surgical morbidity. Ann Surg. 2013;258:1–7.

    Article  PubMed  Google Scholar 

  8. Mentula PJ, Leppäniemi AK. Applicability of the Clavien-Dindo classification to emergency surgical procedures: a retrospective cohort study on 444 consecutive patients. Patients Saf Surg. 2014;8:31. https://www.pssjournal.com/content/8/1/31

    Article  Google Scholar 

  9. Leppäniemi A, Clavien PA. Reporting complications and outcome, are we there yet? Scand J Surg. 2013;102:219–20.

    Article  PubMed  Google Scholar 

  10. Peitzman AB, Leppäniemi A, Kutcher ME, et al. Surgical rescue: an essential component of acute care surgery. Scand J Surg. 2015;104:135–6.

    Article  PubMed  Google Scholar 

  11. Leppäniemi A. Emergency medicine and emergency surgery – where’s the beef? Scand J Surg. 2012;101:2–4.

    Article  PubMed  Google Scholar 

  12. Almoudaris AM, Burns EM, Mamidanna R, et al. Value of failure to rescue as a marker of the standard of care following reoperation for complications after colorectal resection. Br J Surg. 2011;98:1775–83.

    Article  CAS  PubMed  Google Scholar 

  13. Spolverato G, Ejaz A, Hyder O, et al. Failure to rescue as a source of variation in hospital mortality after hepatic surgery. Br J Surg. 2014;101:836–46.

    Article  CAS  PubMed  Google Scholar 

  14. Sheetz KH, Krell RW, Englesbe MJ, et al. The importance of the first complication: understanding failure to rescue after emergent surgery in the elderly. J Am Coll Surg. 2014;219:365–70.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Kaufman EJ, Earl-Royal E, Barie PS, et al. Failure to rescue after infectious complications in a statewide trauma system. Surg Infect. 2017;18:1–10.

    Article  Google Scholar 

  16. Barmparas G, Ley EJ, Martin MJ, et al. Failure to rescue the elderly: a superior quality metric for trauma centers. Eur J Trauma Emerg Surg. 2018;44:377–84.

    Article  CAS  PubMed  Google Scholar 

  17. Silber JH, Williams SV, Krakauer H, et al. Hospital and patient characteristics associated with death after surgery: a study of adverse occurrence and failure-to-rescue. Med Care. 1992;30:615–29.

    Article  CAS  PubMed  Google Scholar 

  18. Ghaferi AA, Birkmeyer JD, Dimick JB. Complications, failure to rescue, and mortality with major inpatient surgery in Medicare patients. Ann Surg. 2009;250:1029–34.

    Article  PubMed  Google Scholar 

  19. Ghaferi AA, Birkmeyer JD, Dimick JB. Variation in hospital mortality associated with inpatient surgery. N Engl J Med. 2009;361:1368–75.

    Article  CAS  PubMed  Google Scholar 

  20. Ferraris VA, Bolanos M, Martin JT, et al. Identification of patients with postoperative complications who are at risk of failure to rescue. JAMA Surg. 2014;149:1103–8.

    Article  PubMed  Google Scholar 

  21. Rhee C, Jones TM, Hamad Y, et al. Prevalence, underlying causes, and preventability of sepsis-associated mortality in US acute care hospitals. JAMA Netw Open. 2019;2:e187571. https://doi.org/10.1001/jamanetworkopen.20187571.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Rosenthal M, Moore FA. Persistent inflammation, immunosuppression, and catabolism: evolution of multiple organ dysfunction. Surg Infect. 2016;17:167–72.

    Article  Google Scholar 

  23. Pucher PH, Aggarwal R, Qurashi M, et al. Meta-analysis of the effect of postoperative in-hospital morbidity on long-term patient survival. Br J Surg. 2014;101:1499–508.

    Article  CAS  PubMed  Google Scholar 

  24. Hatchimonji JS, Kaufman EJ, Sharoky CE, et al. Failure to rescue in surgical patients: a review for acute care surgeons. J Trauma Acute Care Surg. 2019;87:699706.

    Article  Google Scholar 

  25. Sheetz KH, Dimick JB, Ghaferi AA. Impact of hospital characteristics on failure to rescue following major surgery. Ann Surg. 2016;263:692–7.

    Article  PubMed  Google Scholar 

  26. Mehta A, Efron DT, Canner JK, et al. Effect of surgeon and hospital volume on emergency general surgery outcomes. J Am Coll Surg. 2017;225:666–75.

    Article  PubMed  Google Scholar 

  27. Leppäniemi A. Organization of emergency surgery. Br J Surg. 2014;101:e7–8.

    Article  PubMed  Google Scholar 

  28. Catena F, Biffl W, De Simone B, et al. Emergency general surgeons: the special forces of general surgery (the “navy seals paradigm”). World J Emerg Surg. 2020;15:11. https://doi.org/10.1186/s13017-020-0293-7.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Ari Leppäniemi .

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Leppäniemi, A., Tolonen, M. (2023). Rescue Surgery and Failure to Rescue. In: Aseni, P., Grande, A.M., Leppäniemi, A., Chiara, O. (eds) The High-risk Surgical Patient. Springer, Cham. https://doi.org/10.1007/978-3-031-17273-1_38

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  • DOI: https://doi.org/10.1007/978-3-031-17273-1_38

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-17272-4

  • Online ISBN: 978-3-031-17273-1

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