Analysis on Unplanned Reoperation Cases in a Hospital in Beijing
Objectives By analyzing the main department distribution,reasons for reoperation,and influencing factors of unplanned reoperation cases,aiming to further improve the surgical quality and safety management system and enhance the surgical safety management capabilities of medical institutions.Methods To select 56966 discharged surgical cases from January 1st,2023 to December 31st,2023,38 unplanned reoperation cases(reoperation group),and 56928 other surgical cases(non-reoperation group).Separate statistics were conducted on the composition of departments in the reoperation group and the reasons for reoperation.At the same time,the relationship between gender,age,admission method,surgical level,surgical duration,comorbidities,and reoperation of the two groups of cases was analyzed to explore the influencing factors of unplanned reoperation.SPSS 26.0 statistical software was used for data processing.Results The top three departments in terms of unplanned reoperation cases are spinal surgery(36.84%),general surgery(18.42%),trauma orthopedics(10.53%),and orthopedics(10.53%);The main causes of reoperation were postoperative hematoma(42.11%),incision complications(21.05%),poor internal fixation position(7.89%),and nerve injury(7.89%);The results of univariate analysis showed that the reoperation rate of third and fourth level surgeries was significantly higher than that of first and second level surgeries(x2=14.716),the reoperation rate of surgeries with a duration over 3 hours was significantly higher than that of surgeries with a duration below 3 hours(x2=46.812),the reoperation rate of those with coronary heart disease was higher than that of those without coronary heart disease(x2=46.815),and the reoperation rate of those with anemia was higher than that of those without coronary heart disease(x2=63.451).The above results were all P<0.001,and the difference was statistically significant.Conclusions High level surgery and some complications increased the rate of unplanned return to the operating room for reoperation,and postoperative hematoma was the main reason for reoperation.Strengthening perioperative management and strictly implementing the surgical grading management system were important measures to ensure surgical quality and safety.