Postoperative wound dehiscence: Predictors and associations.

MedStar author(s):
Citation: Wound Repair & Regeneration. 23(2):184-90, 2015 Mar-Apr.PMID: 25683272Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: MedStar Heart InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, N.I.H., Extramural | Research Support, Non-U.S. Gov't | Validation StudiesSubject headings: *Comorbidity | *Surgical Wound Dehiscence/di [Diagnosis] | *Wound Healing | Humans | Middle Aged | Patient Safety | Postoperative Period | Predictive Value of Tests | Surgical Wound Dehiscence/pa [Pathology] | Surgical Wound Dehiscence/th [Therapy] | United States | United States Agency for Healthcare Research and QualityYear: 2015ISSN:
  • 1067-1927
Name of journal: Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyAbstract: The Agency for Healthcare Research and Quality patient safety indicators (PSI) were developed as a metric of hospital complication rates. PSI-14 measures postoperative wound dehiscence and specifically how often a surgical wound in the abdominal or pelvic area fails to heal after abdominopelvic surgery. Wound dehiscence is estimated to occur in 0.5-3.4% of abdominopelvic surgeries, and carries a mortality of up to 40%. Postoperative wound dehiscence has been adopted as a surrogate safety outcome measure as it impacts morbidity, length of stay, healthcare costs and readmission rates. Postoperative wound dehiscence cases from the Nationwide Inpatient Sample demonstrate 9.6% excess mortality, 9.4 days of excess hospitalization and All authors: Banerjee AN, Couch KS, Evans KK, Fernandez SJ, McNish S, Mete M, Shanmugam VK, Shara NFiscal year: FY2015Digital Object Identifier: Date added to catalog: 2016-05-24
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Journal Article MedStar Authors Catalog Article 25683272 Available 25683272

The Agency for Healthcare Research and Quality patient safety indicators (PSI) were developed as a metric of hospital complication rates. PSI-14 measures postoperative wound dehiscence and specifically how often a surgical wound in the abdominal or pelvic area fails to heal after abdominopelvic surgery. Wound dehiscence is estimated to occur in 0.5-3.4% of abdominopelvic surgeries, and carries a mortality of up to 40%. Postoperative wound dehiscence has been adopted as a surrogate safety outcome measure as it impacts morbidity, length of stay, healthcare costs and readmission rates. Postoperative wound dehiscence cases from the Nationwide Inpatient Sample demonstrate 9.6% excess mortality, 9.4 days of excess hospitalization and 0,323 in excess hospital charges relative to matched controls. The purpose of the current study was to investigate the associations between PSI-14 and measurable medical and surgical comorbidities using the Explorys technology platform to query electronic health record data from a large hospital system serving a diverse patient population in the Washington, DC and Baltimore, MD metropolitan areas. The study population included 25,636 eligible patients who had undergone abdominopelvic surgery between January 1, 2008 and December 31, 2012. Of these cases, 786 (2.97%) had postoperative wound dehiscence. Patient-associated comorbidities were strongly associated with PSI-14, suggesting that this indicator may not solely be an indicator of hospital safety. There was a strong association between PSI-14 and opioid use after surgery and this finding merits further investigation. Copyright © 2015 by the Wound Healing Society.

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