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Jay M. Stewart, Marcela M. Estrada; Analysis Of Unplanned Return To The Operating Room Following Vitreoretinal Surgery: A First Look At Quality Improvement In Ophthalmology. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6106.
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Quality improvement efforts are gaining increasing importance in the current healthcare environment. Unplanned reoperation has been identified as an objective measure of surgical quality, but no publications have utilized this metric to evaluate quality of care in ophthalmology. In this study, we initiated an effort to analyze the quality of vitreoretinal surgery at a public hospital by determining the incidence of unplanned reoperation and by performing a case-control study to identify risk factors for this occurrence.
All vitreoretinal surgical procedures performed over a 10-year period at San Francisco General Hospital (SFGH) were identified through billing records and operating room logs. We then calculated the incidence of unplanned return to the operating room within 30 and 90 days following a vitreoretinal operation. For every case in which an unplanned return to surgery occurred, we selected four control surgeries, matched on the basis of patient age and month of surgery. Risk factors for unanticipated return to the operating room were to be identified using this comparison.
Over the 10-year period from 1999 to 2009, 580 unique vitreoretinal surgeries were performed at SFGH. The incidence of unplanned return to the operating room within 30 days was 4.5% (n=26) and within 90 days was 6.7% (n=39).
The incidence of unplanned reoperation following vitreoretinal surgery at SFGH was on par with reported rates in other surgical specialties. Identifying risk factors for this occurrence could help to improve patient outcomes following vitreoretinal surgery. Unplanned return to the operating room can be a useful indicator for evaluating quality of surgical care in ophthalmology.
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