Discordance between the patient’s and surgeon’s perception of complications following hernia surgery

Fränneby, Ulf; Gunnarsson, Ulf; Wollert, Staffan; Sandblom, Gabriel

doi:10.1007/s10029-004-0310-x

Cited by 35 publications

(34 citation statements)

References 19 publications

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“…75 The correlation between surgeon and patient opinions of operative outcomes is poor. 36,65 Our results indicate that retrospective reviews underestimate the incidence of complications in spine surgery. Overall, prospective studies reported a higher incidence of complications (19.9%) than did retrospective studies (16.1%, p < 0.0001, OR 1.3).…”

Section: Relevance Of Study Designmentioning

confidence: 77%

Complications in spine surgery

Nasser

Yadla²,

Maltenfort³

et al. 2010

SPI

312

167

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Object The overall incidence of complications or adverse events in spinal surgery is unknown. Both prospective and retrospective analyses have been performed, but the results have not been critically assessed. Procedures for different regions of the spine (cervical and thoracolumbar) and the incidence of complications for each have been reported but not compared. Authors of previous reports have concentrated on complications in terms of their incidence relevant to healthcare providers: medical versus surgical etiology and the relevance of perioperative complications to perioperative events. Few authors have assessed complication incidence from the patient's perspective. In this report the authors summarize the spine surgery complications literature and address the effect of study design on reported complication incidence. Methods A systematic evidence-based review was completed to identify within the published literature complication rates in spinal surgery. The MEDLINE database was queried using the key words “spine surgery” and “complications.” This initial search revealed more than 700 articles, which were further limited through an exclusion process. Each abstract was reviewed and papers were obtained. The authors gathered 105 relevant articles detailing 80 thoracolumbar and 25 cervical studies. Among the 105 articles were 84 retrospective studies and 21 prospective studies. The authors evaluated the study designs and compared cervical, thoracolumbar, prospective, and retrospective studies as well as the durations of follow-up for each study. Results In the 105 articles reviewed, there were 79,471 patients with 13,067 reported complications for an overall complication incidence of 16.4% per patient. Complications were more common in thoracolumbar (17.8%) than cervical procedures (8.9%; p < 0.0001, OR 2.23). Prospective studies yielded a higher incidence of complications (19.9%) than retrospective studies (16.1%; p < 0.0001, OR 1.3). The complication incidence for prospective thoracolumbar studies (20.4%) was greater than that for retrospective series (17.5%; p < 0.0001). This difference between prospective and retrospective reviews was not found in the cervical studies. The year of study publication did not correlate with the complication incidence, although the duration of follow-up did correlate with the complication incidence (p = 0.001). Conclusions Retrospective reviews significantly underestimate the overall incidence of complications in spine surgery. This analysis is the first to critically assess differing complication incidences reported in prospective and retrospective cervical and thoracolumbar spine surgery studies.

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Section: Relevance Of Study Designmentioning

confidence: 77%

Complications in spine surgery

Nasser

Yadla²,

Maltenfort³

et al. 2010

SPI

312

167

View full text Add to dashboard Cite

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“…18 The accuracy of patient reports of medical complications has not been investigated as thoroughly among surgical patients. Existing studies have been limited to either a single type of surgery 19–21 or to a single postoperative complication. 22–24 Additional characterization of PROs in a diverse surgical population is necessary if they are to be used to identify postoperative complications for clinical care, for research, or for quality improvement.…”

Section: Introductionmentioning

confidence: 99%

The Gynaecologic Leiden Questionnaire: psychometric properties of a self‐report questionnaire of sexual function and vaginal changes for gynaecological cancer patients

et al. 2007

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Background Anesthesiologists need tools to accurately track postoperative outcomes. The accuracy of patient report in identifying a wide variety of postoperative complications following diverse surgical procedures has not previously been investigated. Methods In this cohort study, 1578 adult surgical patients completed a survey at least 30 days after their procedure asking if they had experienced any of 18 complications while in the hospital after surgery. Patient responses were compared to the results of an automated electronic chart review and (for a random subset of 750 patients) to a manual chart review. Results from automated chart review were also compared to those from manual chart review. Forty-two randomly selected patients were contacted by telephone to explore reasons for discrepancies between patient report and manual chart review. Results Comparisons between patient report, automated chart review, and manual chart review demonstrated poor-to-moderate positive agreement (range 0% to 58%) and excellent negative agreement (range 82% to 100%). Discordance between patient report and manual chart review were was frequently explicable by patients reporting events that happened outside the time period of interest. Conclusions Patient report can provide information about subjective experiences or events that happen after hospital discharge, but often yields different results from chart review for specific in-hospital complications. Effective in-hospital communication with patients and thoughtful survey design may increase the quality of patient-reported complication data. This is a substudy of the SATISFY-SOS surgical outcomes registry (NCT02032030).

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“…Algunos analizan los factores que influyen en el retorno del paciente a las actividades diarias después de una cirugía herniaria 4,7 , otros investigan el rol de la inguinodinia en la satisfacción del paciente con su cirugía 6,9,[17][18][19] . El cuestionario genérico de salud abreviado (SF-36) es frecuentemente empleado en muchos estudios 1,4,8 y también se han aplicado simples cuestionarios indagando la satisfacción subjetiva del paciente con su cirugía 10,20 . Tomando en cuenta estas experiencias desarrollamos el ICCRHL 2,3 , el cual considera los conceptos de la Calidad de Vida Relacionada con la Salud y evalúa mediante preguntas simples la percepción subjetiva del paciente respecto a su cirugía y los resultados objetivos de la misma.…”

Section: Discussionunclassified

“…La satisfacción subjetiva del paciente con su cirugía, evaluada por la pregunta 6, demuestra que la insatisfacción del paciente en los primeros meses después de la cirugía se debe a las complicaciones sufridas en el postoperatorio; a pesar de que desde el punto de vista del cirujano estas complicaciones pueden considerarse como relativamente menores, para el paciente son una causa importante de ansiedad y consiguiente insatisfacción 20 . El incremento de pacientes insatisfechos en el control del primer año y de los 2 años se debe al desarrollo de inguinodinia, la cual constituye una causa importante de insatisfacción con la cirugía [17][18][19][20] . La disposición del paciente hacia una nueva cirugía constituye otro aspecto que evalúa la calidad y los resultados de la cirugía inicial por hernia inguinal 7 , Durante los primeros controles el número de pacientes que no se operaría nuevamente se mantuvo constante y la razón principal para rechazar una nueva cirugía fue la edad avanzada; en el control de los 2 años, este número de pacientes renuentes aumentó en casi un 50% debido principalmente al desarrollo de inguinodinia.…”

Section: Discussionunclassified

See 1 more Smart Citation

Resultados a corto plazo de la hernioplastia inguinal: Seguimiento prospectivo de 112 pacientes

Beltran¹,

Marcelo²

2008

Rev Chil Cir

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TRABAJO DE INGRESO RESUMENIntroducción: Creemos que eventualmente los resultados de la hernioplastía de Lichtenstein sufrirán cambios objetivos y subjetivos según la percepción de cada paciente. El objetivo fue evaluar mediante el Instrumento de medición Cualitativo y Cuantitativo (ICCRHL) los resultados de la hernioplastía de Lichtenstein en una cohorte específica de pacientes y analizar los cambios que en estos podrían ocurrir. Pacientes y método: Los pacientes masculinos mayores de 15 años electivamente operados por hernia inguinal entre Enero y Diciembre del 2004 fueron seguidos prospectivamente mediante entrevista, examen físico y llenado de una forma pre-impresa del ICCRHL un mes después de la cirugía, a los 6 meses, 1 año y 2 años. Resultados: El 70,5% de los pacientes obtuvieron resultados excelentes a los 6 meses los cuales se mantuvieron a los 2 años. Los mejores resultados se obtuvieron en el control del primer año. Los resultados muy malos tuvieron una distribución bimodal, presentándose con mayor frecuencia en el primer control y observándose un importante incremento en el control de los 2 años; la causa fue el desarrollo de inguinodinia. Conclusión: De acuerdo al ICCRHL, los resultados de la hernioplastía de Lichtenstein son diferentes según el momento del tiempo en el cual son medidos. Este hecho demuestra que los resultados de una cirugía funcional como ésta, son dinámicos, varían según el momento en el cual son evaluados y sufren cambios importantes con el tiempo.PALABRAS CLAVE: Hernioplastía de Lichtenstein, calidad de vida, complicaciones quirúrgicas. ABSTRACTBackground: Eventually the outcomes of Lichtenstein hernioplasty will experience objective and subjective changes according to the perception of every individual patient. Aim: To evaluate the outcomes of Lichtenstein hernioplasty using the Quantitative and Qualitative Measurement Instrument (QQMI), in a specific cohort of patients and to analyze the changes that may occur. Patients and methods: One hundred and twelve male patients, aged 17 to 92 years, electively operated for inguinal hernia from January to December 2004, were enrolled in a prospective protocol and subjected to assessments that included an

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Discordance between the patient’s and surgeon’s perception of complications following hernia surgery

Cited by 35 publications

References 19 publications

Complications in spine surgery

Complications in spine surgery

The Gynaecologic Leiden Questionnaire: psychometric properties of a self‐report questionnaire of sexual function and vaginal changes for gynaecological cancer patients

Resultados a corto plazo de la hernioplastia inguinal: Seguimiento prospectivo de 112 pacientes

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