CORR Insights®: Can Surgeons Adequately Capture Adverse Events Using the Spinal Adverse Events Severity System (SAVES) and OrthoSAVES?

Rampersaud, Y. Raja

doi:10.1007/s11999-016-5142-3

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…10 A recent commentary also mentions "professional shaming" and the need for qualitative analyses that can add insight into why surgeons may feel it is not necessary to report the more frequent minor AEs. 11 It is essential that we simplify the process of prospectively recording AEs and make the tools used to record AEs as applicable as possible to a wide range of specialties.…”

Section: What Does It All Mean?mentioning

confidence: 99%

Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting

Garland

Chen

Poitras

et al. 2020

CJS

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Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting E nsuring adverse event (AE) recording is standardized and accurate can bring about improvements in patient care, and may help hospitals track quality-improvement indexes, leading to improved postoperative outcomes and reduced expenditures. However, there is still no one method, tool or protocol that is effective at capturing all AEs. The Spine Adverse Events Severity System (SAVES) has been successfully implemented to record AEs in spine surgery. 1 The Orthopedic Surgical Adverse Events Severity System (OrthoSAVES) is a modification of SAVES that has been used to record AEs in general orthopedic surgery procedures. 2 By using SAVES and OrthoSAVES, we previously showed that independent clinical reviewers reported more AEs than orthopedic surgeons in elective orthopedic surgical patients. 3 Currently, AEs are often captured by hospital administrative discharge abstract coders via a retrospective review of physician directives in medical charts after discharge. This can be inefficient and incomplete owing to the nature of the coding, and can often not be linked back directly to the chart itself. 4 In this discussion we outline our comparison of AE data recorded by orthopedic surgeons and independent clinical reviewers using SAVES and OrthoSAVES against AE data recorded by hospital administrative discharge abstract coders as well as our assessment of the appropriateness of using OrthoSAVES across the general orthopedic surgery population, including spine patients. What We did All elective orthopedic surgical patients operated on by 1 of 6 surgeons (3 spine, 1 hip, 1 knee, and 1 shoulder) over a 10-week period at a tertiary-care teaching hospital were included. Emergency and oncology

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Section: What Does It All Mean?mentioning

confidence: 99%

Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting

Garland

Chen

Poitras

et al. 2020

CJS

View full text Add to dashboard Cite

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Quality and safety improvement initiatives in complex spine surgery

Sethi

Buchlak

Lévêque

et al. 2018

Seminars in Spine Surgery

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Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study

et al. 2022

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Background Recent systematic reviews support that non-operative management should be the standard treatment for all stable isolated lateral malleolar fractures (ILMFs), regardless of fibular fracture displacement. Surgical fixation of ILMFs carries a risk of adverse events (AEs), and many patients will later require implant removal. We wanted to estimate the incidence of AEs requiring revision after surgical fixation of “potentially stable” displaced ILMFs before non-operative treatment became standard care in our department. Materials and methods To identify patients with “potentially stable” ILMFs who had been treated surgically in a historical cohort, we retrospectively applied the stability-based classification system, introduced by Michelson et al., to a cohort of 1006 patients with ankle fractures treated surgically from 2011 to 2016. The primary outcome of this retrospective cohort study was the incidence of AEs that had functionally significant adverse effects on outcome and required revision in the first 12 months after surgery. AEs were graded and categorized using the Orthopedic Surgical Adverse Events Severity (OrthoSAVES) System. Results The study population comprised 108 patients with “potentially stable” displaced ILMFs; 4 patients (3.7% [95% CI (0.1–7.3%]) experienced AEs requiring revision in the first twelve months after surgery. There were 5 additional patients (4.6%) with functionally significant AEs where revision surgery was not indicated within the first twelve months after surgical fixation. A further 5 patients (4.6%) had AEs managed in the outpatient clinic (grade II); 36 patients (33.3%) required secondary implant removal due to implant-related discomfort. Conclusions Surgical fixation of ILMFs carries a risk of severe AEs, and many patients will subsequently need implant-removal procedures. Further prospective studies are required to ascertain whether non-operative treatment can lower the risk of AEs and the need for additional surgical procedures.

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CORR Insights®: Can Surgeons Adequately Capture Adverse Events Using the Spinal Adverse Events Severity System (SAVES) and OrthoSAVES?

Cited by 4 publications

References 14 publications

Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting

Capturing adverse events in elective orthopedic surgery: comparison of administrative, surgeon and reviewer reporting

Quality and safety improvement initiatives in complex spine surgery

Surgical treatment of displaced isolated lateral malleolar fractures: incidence of adverse events requiring revision: a retrospective cohort study

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