Textbook outcomes in heart transplantation: A quality metric for the modern era

Bakhtiyar, Syed Shahyan; Ali, Konmal; Coaston, Troy; Verma, Arjun; Chervu, Nikhil; Benharash, Peyman

doi:10.1016/j.surg.2023.03.014

Cited by 3 publications

(1 citation statement)

References 32 publications

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“…There has been a recent increase in interest in the use of Textbook Outcomes (TOs) for elective surgery, including colorectal 1 , oesophagogastric 2 , bariatric 3 , hepatobiliary 4 , gynaecological 5 and cardiac 6 surgery. These TOs are composite outcome measures that seek to better describe the ‘ideal’ outcome for patients.…”

Section: Introductionmentioning

confidence: 99%

Novel Textbook Outcomes following emergency laparotomy: Delphi exercise

Naumann,

Bhangu,

Brooks

et al. 2024

BJS Open

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Background Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the best Textbook Outcomes for non-trauma and trauma emergency laparotomy. Methods A modified Delphi exercise was undertaken with three planned rounds to achieve consensus regarding the best Textbook Outcomes based on the category, number and importance (Likert scale of 1–5) of individual outcome measures. There were separate questions for non-trauma and trauma. A patient engagement exercise was undertaken after round 2 to inform the final round. Results A total of 337 participants from 53 countries participated in all three rounds of the exercise. The final Textbook Outcomes were divided into ‘early’ and ‘longer-term’. For non-trauma patients the proposed early Textbook Outcome was ‘Discharged from hospital without serious postoperative complications (Clavien–Dindo ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation or death). For trauma patients it was ‘Discharged from hospital without unexpected transfusion after haemostasis, and no serious postoperative complications (adapted Clavien–Dindo for trauma ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation on or death)’. The longer-term Textbook Outcome for both non-trauma and trauma was ‘Achieved the early Textbook Outcome, and restoration of baseline quality of life at 1 year’. Conclusion Early and longer-term Textbook Outcomes have been agreed by an international consensus of experts for non-trauma and trauma emergency laparotomy. These now require clinical validation with patient data.

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Section: Introductionmentioning

confidence: 99%

Novel Textbook Outcomes following emergency laparotomy: Delphi exercise

Naumann,

Bhangu,

Brooks

et al. 2024

BJS Open

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Heart Transplantation After Donation After Circulatory Death: Early United States Experience

Bakhtiyar,

Sakowitz,

Mallick

et al. 2024

The Annals of Thoracic Surgery

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Textbook Outcomes in Solid Transplantation: A Systematic Review

Martinino,

Ladowski,

Schilirò

et al. 2024

Transplantation Direct

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Background. The concept of TO is expanding across various surgical disciplines to establish a standardized, comprehensive quality benchmark. Traditional metrics such as 1-y patient and graft survival have been key for evaluating transplant program performance but are now deemed inadequate because of significant field advancements. This systematic review aims to provide a comprehensive understanding of the applicability and validity of textbook outcome (TO) in the setting of solid organ transplantation. Methods. A structured search, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, was conducted across PubMed, Embase, and Scopus databases on March 10, 2024. Results. Fourteen articles were identified for inclusion in this review. Of these, 2 studies addressed TO in heart transplantation, 3 in lung transplantation, 2 in kidney transplantation, and 7 in liver transplantation. A subgroup analysis was conducted to categorize the different definitions of TOs and identify the most common reasons for TO failure. Conclusions. Our systematic review highlights the ongoing efforts in the field of solid organ transplantation to define TO and emphasizes the importance of developing a universally recognized set of TO criteria for each type of transplant. TO provides a valuable framework for transplant centers to benchmark their performance against similar institutions on a risk-adjusted basis and to pinpoint specific areas for enhancing patient outcomes. Even the most successful programs may discover aspects within the composite outcome with scope for improvement.

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Textbook outcomes in heart transplantation: A quality metric for the modern era

Cited by 3 publications

References 32 publications

Novel Textbook Outcomes following emergency laparotomy: Delphi exercise

Novel Textbook Outcomes following emergency laparotomy: Delphi exercise

Heart Transplantation After Donation After Circulatory Death: Early United States Experience

Textbook Outcomes in Solid Transplantation: A Systematic Review

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