Determining the safety of office-based surgery: what 10 years of Florida data and 6 years of Alabama data reveal.

نویسندگان

  • John Starling
  • Maya K Thosani
  • Brett M Coldiron
چکیده

BACKGROUND This is a continued examination of 10 years of prospectively collected Florida in-office adverse event data and new comparable data from mandatory Alabama in-office adverse event data reporting. OBJECTIVE To determine which office surgical procedures have resulted in reported complications. METHODS This study is a compilation of mandatory reporting of office surgical complications by Florida and Alabama physicians to a central agency. Reports resulting in death or a hospital transfer were further investigated over the telephone or on-line to determine the reporting physician's board certification status, hospital privilege status, and office accreditation status. RESULTS In 10 years in Florida, there were 46 deaths and 263 procedure-related complications and hospital transfers; 56.5% (26/46) of deaths and 49.8% (131/263) of hospital transfers were associated with non-medically necessary (cosmetic) procedures. The majority of deaths (67%) and hospital transfers (74%) related to non-medically necessary (cosmetic) procedures were from procedures performed on patients under general anesthesia. Liposuction and liposuction with abdominoplasty or other cosmetic procedure resulted in 10 deaths and 34 hospital transfers. Thirty-eight percent of offices reporting adverse events were accredited by an independent accrediting agency, 93% of physicians were board certified, and 98% of physicians had hospital privileges. The most common specialty of physicians reporting adverse events was plastic surgery (45% of all reported complications). Dermatologists reported four total complications (no deaths) and accounted for 1.3% of all complications over the 10-year period. In 6 years in Alabama, there were three deaths and 49 procedure-related complications and hospital transfers; 42% (22/52) of hospital transfers and no deaths were associated with non-medically necessary (cosmetic) procedures. The majority of hospital transfers related to cosmetic procedures (86%) were from procedures performed on patients under general anesthesia. Liposuction accounted for no deaths and two hospital transfers. Seventy-one percent of offices reporting adverse events were accredited by an independent accrediting agency, and 100% of physicians were board-certified. Plastic surgery was the most common specialty represented in adverse event reporting (42.3% of all reported complications). Dermatologists reported one complication (no deaths) and accounted for 1.9% of all complications over the 6-year period. CONCLUSIONS Continued analysis reveals that medically necessary office surgery does not represent an emergent hazard to patients. The data obtained from 10 and 6 years of adverse event reporting in Florida and Alabama, respectively, are comparable and consistent. Medically necessary surgical procedures performed in the office setting by dermatologists have an exceedingly low complication rate, and complications that arose were largely unexpected, isolated, and possibly unpreventable. Cosmetic procedures performed in offices by dermatologists under local and dilute local anesthesia yielded no reported complications. Complications from cosmetic procedures accounted for nearly half of all reported incidents in Florida and Alabama, and in both states, plastic surgeons were most represented in adverse event reports. Liposuction performed under general anesthesia requires further investigation because deaths from this procedure continue to occur despite the ability to use dilute local anesthesia for this procedure. Requiring physician board certification and physician hospital privileges does not seem to increase safety of patients undergoing surgical procedures in the office setting. Mandatory reporting of adverse events in the office setting should continue to be championed. Reporting of delayed deaths after hospital outpatient and ambulatory surgery center procedures should be implemented. All data should be made available for scientific analysis after protecting patient confidentiality.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

O5: Children Need Our Protection Poly Trauma in Children-What Makes the Difference

Children are not little adults. Children have a limited responsibility corresponding to their age. Germany experiences a steady decline of Road Traffic Injuries and Fatalities in children to 28 674 injured children under 15 years and to 71 fatal injured children in 2014. In the European :::::union::::: similar data are available, but with a major difference between the countries. An evaluation ...

متن کامل

Evaluating The Usability of a Web Software and Determining its Correlation with Fatigue and Burnout Factor in Office Personnel of a Health Center in Tehran City

 Introduction: The importance of assessing and identifying ergonomic risk factors in the workplace among office workers has increased with the increase in occupational tasks of computer and increasing the risk of physical and mental disorders among its users. One of these factors is the usability of computer hardware and software. The purpose of this study was to evaluate the applicability of o...

متن کامل

بررسی کارایی اتاق عمل‌های بیمارستان‌های آموزشی درمانی دانشگاه علوم پزشکی شیراز با استفاده از روش تحلیل پوششی داده‌ها: 1393-1391

Introduction: The operating room efficiency is one of the main factors in determining hospital expenses leading to an increase in the capacity of operating rooms, along with an increase in quality and enhanced financial capacity of hospitals. The purpose of this study was to determine the efficiency of operating rooms of teaching hospitals of Shiraz University of Medical Sciences. Methods: Thi...

متن کامل

Frequency of complaints referred by patients from the dental profession in the fields of treatment of oral and maxillofacial surgery, periodontal, oral & maxillofacial medicine, oral & maxillofacial pathology to the Office of Forensic Medicine Commis

Abstract Background & Aim: Considering the increase in complaints and its negative impact on the quality of dental services, it seems necessary to review complaint files.The aim of this study was to determine the frequency of complaints referred by patients to dental professionals in the field of oral and maxillofacial surgery, periodontal, oral & maxillofacial medicine, oral & maxillofacial pa...

متن کامل

بررسی میزان مراجعه بیماران برای انجام درمانهای پیشگیرانه پس از درمان جراحی لثه

Introduction: Supportive periodontal treatment prevents the progress and recurrence of periodontal disease in patients previously diagnosed and treated for periodontitis, decreases tooth loss and increases the possibility for treating other diseases or conditions resulting from oral pathologies. Therefore, the present study aimed to determine the frequency of patients' returns for gingival chec...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]

دوره 38 2  شماره 

صفحات  -

تاریخ انتشار 2012