PMID- 28856354
OWN - NLM
STAT- MEDLINE
DCOM- 20180511
LR  - 20220408
IS  - 1934-3418 (Electronic)
IS  - 1078-4519 (Linking)
VI  - 46
IP  - 4
DP  - 2017 Jul/Aug
TI  - Severity Weighting of Postoperative Adverse Events in Orthopedic Surgery.
PG  - E235-E243
AB  - Studies of adverse events (AEs) after orthopedic surgery commonly use composite 
      AE outcomes. An example of such an outcome is any AE. These types of outcomes 
      treat AEs with different clinical significance (eg, death, urinary tract 
      infection) similarly. We conducted a study to address this shortcoming in 
      research methodology by creating a single severity-weighted outcome that can be 
      used to characterize the overall severity of a given patient's postoperative 
      course. All orthopedic faculty members at 2 academic institutions were invited to 
      complete a severity-weighting exercise in which AEs were assigned a percentage 
      severity of death. Mean (standard error) severity weight for urinary tract 
      infection was 0.23% (0.08%); blood transfusion, 0.28% (0.09%); pneumonia, 0.55% 
      (0.15%); hospital readmission, 0.59% (0.23%); wound dehiscence, 0.64% (0.17%); 
      deep vein thrombosis, 0.64% (0.19%); superficial surgical-site infection, 0.68% 
      (0.23%); return to operating room, 0.91% (0.29%); progressive renal 
      insufficiency, 0.93% (0.27%); graft/prosthesis/flap failure, 1.20% (0.34%); 
      unplanned intubation, 1.38% (0.53%); deep surgical-site infection, 1.45% (0.38%); 
      failure to wean from ventilator, 1.45% (0.48%); organ/space surgical-site 
      infection, 1.76% (0.46%); sepsis without shock, 1.77% (0.42%); peripheral nerve 
      injury, 1.83% (0.47%); pulmonary embolism, 2.99% (0.76%); acute renal failure, 
      3.95% (0.85%); myocardial infarction, 4.16% (0.98%); septic shock, 7.17% (1.36%); 
      stroke, 8.73% (1.74%); cardiac arrest requiring cardiopulmonary resuscitation, 
      9.97% (2.46%); and coma, 15.14% (3.04%). Future studies may benefit from using 
      this new severity-weighted outcome score.
FAU - Bohl, Daniel D
AU  - Bohl DD
FAU - Ahn, Junyoung
AU  - Ahn J
FAU - Lukasiewicz, Adam M
AU  - Lukasiewicz AM
FAU - Samuel, Andre M
AU  - Samuel AM
FAU - Webb, Matthew L
AU  - Webb ML
FAU - Basques, Bryce A
AU  - Basques BA
FAU - Golinvaux, Nicholas S
AU  - Golinvaux NS
FAU - Singh, Kern
AU  - Singh K
FAU - Grauer, Jonathan N
AU  - Grauer JN
AD  - Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New 
      Haven, CT. jonathan.grauer@yale.edu.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Orthop (Belle Mead NJ)
JT  - American journal of orthopedics (Belle Mead, N.J.)
JID - 9502918
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Orthopedic Procedures/*adverse effects
MH  - Postoperative Complications/*diagnosis
MH  - Postoperative Period
MH  - Severity of Illness Index
COIS- Authors' Disclosure Statement: The authors report no actual or potential conflict 
      of interest in relation to this article.
EDAT- 2017/09/01 06:00
MHDA- 2018/05/12 06:00
CRDT- 2017/09/01 06:00
PHST- 2017/09/01 06:00 [entrez]
PHST- 2017/09/01 06:00 [pubmed]
PHST- 2018/05/12 06:00 [medline]
PST - ppublish
SO  - Am J Orthop (Belle Mead NJ). 2017 Jul/Aug;46(4):E235-E243.