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71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21.06. - 24.06.2020

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The rise of quality indicators in neurosurgery – 30-day unplanned reoperation rate evaluated in 3760 patients – a single-centre experience

Qualitätsindikatoren in der Neurochirurgie – 30-tägige ungeplante Reoperationsrate bei 3760 Patienten – Erfahrung einer neurochirurgischen Klinik

Meeting Abstract

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  • presenting/speaker Eric Suero Molina - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Cheyenne Schildmacher - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Justin Doods - Westfälische Wilhelms-Universität Münster, Institut für Medizinische Informatik, Münster, Deutschland
  • Moritz Freistühler - Universitätsklinikum Münster, Controlling Department, Münster, Deutschland
  • Sönke Josua Hellwig - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Walter Stummer - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland
  • Stephanie Schipmann-Miletic - Universitätsklinikum Münster, Klinik für Neurochirurgie, Münster, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. sine loco [digital], 21.-24.06.2020. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocV293

doi: 10.3205/20dgnc289, urn:nbn:de:0183-20dgnc2891

Veröffentlicht: 26. Juni 2020

© 2020 Suero Molina et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

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Objective: Quality indicators are emerging as tools to evaluate health care outcomes. Few studies have evaluated indicators suitable for neurosurgery so far. Among others, reoperation rate has been suggested as a possible indicator. We aimed to evaluate the reoperation rate in a large neurosurgery adult collective.

Methods: In this exploratory post-hoc analysis we evaluated all patients operated in our service for elective and emergency surgery between January 2014 and May 2016. Planned and unplanned reoperations were filtered and a quantitative analysis, including uni- and multivariate analyses, was performed.

Results: A total of 3760 patients were included in this evaluation. From 378 reoperated patients within 30-days (10.1%), 51 underwent planned procedures (1.4%). 327 patients (8.7%) represented the analyzed collective of patients having undergone unplanned surgical procedures, causing a total of 409 from 4268 additional procedures (9.6%). Early unplanned 7-days reoperation rate was 4.5% (n=193), occurring in 4.5% of patients (n=193). Postoperative hemorrhage (n=107, 26.2%) and external ventricle drainage-associated infections or dislocation (n=105, 25.7 %) were the most common indication for unplanned surgery.

Conclusion: Unplanned re-operation rate of a neurosurgical service can help to internally evaluate health care outcome and improve quality of care. Benchmarking with this indicator however is not recommendable as results can vary distinctly due to the heterogenic patient collective of each institution. We expect unplanned reoperation rates to be higher in large university hospitals and tertiary centers with complex cases, as compared to center with less complex cases treating patients with lower morbidity. In this study, we deliver an authentic portrait of a large neurosurgical center in Germany.