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Timing of adverse events in patients undergoing acute and elective hip arthroplasty surgery : A multicentre cohort study using the Global Trigger Tool

Magnéli, Martin ; Kelly-Pettersson, Paula ; Rogmark, Cecilia LU ; Gordon, Max ; Sköldenberg, Olof and Unbeck, Maria (2023) In BMJ Open 13(6).
Abstract

Objective To explore timing in relation to all types of adverse events (AEs), severity and preventability for patients undergoing acute and elective hip arthroplasty. Design A multicentre cohort study using retrospective record review with Global Trigger Tool methodology in combination with data from several registers. Setting 24 hospitals in 4 major regions of Sweden. Participants Patients ≥18 years, undergoing acute or elective total or hemiarthroplasty of the hip, were eligible for inclusion. Reviews of weighted samples of 1998 randomly selected patient records were carried out using Global Trigger Tool methodology. The patients were followed for readmissions up to 90 days postoperatively throughout the whole country. Results The... (More)

Objective To explore timing in relation to all types of adverse events (AEs), severity and preventability for patients undergoing acute and elective hip arthroplasty. Design A multicentre cohort study using retrospective record review with Global Trigger Tool methodology in combination with data from several registers. Setting 24 hospitals in 4 major regions of Sweden. Participants Patients ≥18 years, undergoing acute or elective total or hemiarthroplasty of the hip, were eligible for inclusion. Reviews of weighted samples of 1998 randomly selected patient records were carried out using Global Trigger Tool methodology. The patients were followed for readmissions up to 90 days postoperatively throughout the whole country. Results The cohort consisted of 667 acute and 1331 elective patients. Most AEs occurred perioperatively and postoperatively (n=2093, 99.1%) and after discharge (n=1142, 54.1%). The median time from the day of surgery to the occurrence of AE was 8 days. The median days for different AE types ranged from 0 to 24.5 for acute and 0 to 71 for elective patients and peaked during different time periods. 40.2% of the AEs, both major and minor, occurred within postoperative days 0-5 and 86.9% of the AEs occurred within 30 days. Most of the AEs were deemed to be of major severity (n=1370, 65.5%) or preventable (n=1591, 76%). Conclusions A wide variability was found regarding the timing of different AEs with the majority occurring within 30 days. The timing and preventability varied regarding the severity. Most of the AEs were deemed to be preventable and/or of major severity. To increase patient safety for patients undergoing hip arthroplasty surgery, a better understanding of the multifaceted nature of the timing of AEs in relation to the occurrence of differing AEs is needed.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult orthopaedics, Hip, Orthopaedic & trauma surgery
in
BMJ Open
volume
13
issue
6
article number
e064794
publisher
BMJ Publishing Group
external identifiers
  • pmid:37295831
  • scopus:85162854662
ISSN
2044-6055
DOI
10.1136/bmjopen-2022-064794
language
English
LU publication?
yes
id
9a13d393-58e4-4640-a850-c81997b236cb
date added to LUP
2023-09-18 14:44:40
date last changed
2024-04-19 01:21:12
@article{9a13d393-58e4-4640-a850-c81997b236cb,
  abstract     = {{<p>Objective To explore timing in relation to all types of adverse events (AEs), severity and preventability for patients undergoing acute and elective hip arthroplasty. Design A multicentre cohort study using retrospective record review with Global Trigger Tool methodology in combination with data from several registers. Setting 24 hospitals in 4 major regions of Sweden. Participants Patients ≥18 years, undergoing acute or elective total or hemiarthroplasty of the hip, were eligible for inclusion. Reviews of weighted samples of 1998 randomly selected patient records were carried out using Global Trigger Tool methodology. The patients were followed for readmissions up to 90 days postoperatively throughout the whole country. Results The cohort consisted of 667 acute and 1331 elective patients. Most AEs occurred perioperatively and postoperatively (n=2093, 99.1%) and after discharge (n=1142, 54.1%). The median time from the day of surgery to the occurrence of AE was 8 days. The median days for different AE types ranged from 0 to 24.5 for acute and 0 to 71 for elective patients and peaked during different time periods. 40.2% of the AEs, both major and minor, occurred within postoperative days 0-5 and 86.9% of the AEs occurred within 30 days. Most of the AEs were deemed to be of major severity (n=1370, 65.5%) or preventable (n=1591, 76%). Conclusions A wide variability was found regarding the timing of different AEs with the majority occurring within 30 days. The timing and preventability varied regarding the severity. Most of the AEs were deemed to be preventable and/or of major severity. To increase patient safety for patients undergoing hip arthroplasty surgery, a better understanding of the multifaceted nature of the timing of AEs in relation to the occurrence of differing AEs is needed.</p>}},
  author       = {{Magnéli, Martin and Kelly-Pettersson, Paula and Rogmark, Cecilia and Gordon, Max and Sköldenberg, Olof and Unbeck, Maria}},
  issn         = {{2044-6055}},
  keywords     = {{Adult orthopaedics; Hip; Orthopaedic & trauma surgery}},
  language     = {{eng}},
  number       = {{6}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{Timing of adverse events in patients undergoing acute and elective hip arthroplasty surgery : A multicentre cohort study using the Global Trigger Tool}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2022-064794}},
  doi          = {{10.1136/bmjopen-2022-064794}},
  volume       = {{13}},
  year         = {{2023}},
}