- 作者：Bruce Lee Hall ; Mitzi Hirbe ; Yan Yan ; Shukri F. Khuri ; William G. Henderson ; Barton H. Hamilton
- 刊名：Journal of the American College of Surgeons
- 出版年：2007
- 出版时间：June 2007
- 年：2007
- 卷：204
- 期：6
- 页码：1222-1234
- 全文大小：134 K
Background
There is increasing interest in surgical outcomes. The Patient Safety in Surgery (PSS) Study database was examined about thyroid and parathyroid procedures to determine risk factors for adverse outcomes and outcomes rates. Relative outcomes performance for the Veterans Affairs (VA) and private-sector populations was compared after risk adjustment.Study Design
Preoperative, operative, and postoperative data were analyzed for 7,082 patients: 2,814 VA patients and 4,268 private sector patients. Prevalence of risk or process factors was described. Occurrence rates and unadjusted odds ratios (OR) for adverse outcomes were calculated. Stepwise multiple logistic regressions were performed to model the impact of various factors on outcomes and to calculate the adjusted OR for any adverse event for the VA population compared with the private sector.
Results
Overall mortality rate was 0.35 % and 0.60 % in the VA and 0.19 % in the private sector. Overall rate of any adverse outcomes was 2.90 % and 4.48 % in the VA and 1.97 % in the private sector. Adjusted OR for thyroid versus parathyroid operation was 0.94 (95 % CI, 0.67−1.31). Adjusted OR for operation in the VA versus private sector was 1.25 (95 % CI, 0.87−1.78).
Conclusions
Overall rates of mortality and any morbidity were low and consistent with previous reports. Based on adjusted OR, there was no significant difference in outcomes for thyroid versus parathyroid operation. Similarly, there was no apparent significant difference in surgical outcomes between the VA and private-sector groups after risk adjustment.