TY - JOUR
T1 - Thyroid and Parathyroid Operations in Veterans Affairs and Selected University Medical Centers
T2 - Results of the Patient Safety in Surgery Study
AU - Hall, Bruce Lee
AU - Hirbe, Mitzi
AU - Yan, Yan
AU - Khuri, Shukri F.
AU - Henderson, William G.
AU - Hamilton, Barton H.
PY - 2007/6
Y1 - 2007/6
N2 - Background: There is increasing interest in surgical outcomes. The Patient Safety in Surgery (PSS) Study database was examined about thyroid and parathyroid procedures to determine risk factors for adverse outcomes and outcomes rates. Relative outcomes performance for the Veterans Affairs (VA) and private-sector populations was compared after risk adjustment. Study Design: Preoperative, operative, and postoperative data were analyzed for 7,082 patients: 2,814 VA patients and 4,268 private sector patients. Prevalence of risk or process factors was described. Occurrence rates and unadjusted odds ratios (OR) for adverse outcomes were calculated. Stepwise multiple logistic regressions were performed to model the impact of various factors on outcomes and to calculate the adjusted OR for any adverse event for the VA population compared with the private sector. Results: Overall mortality rate was 0.35% and 0.60% in the VA and 0.19% in the private sector. Overall rate of any adverse outcomes was 2.90% and 4.48% in the VA and 1.97% in the private sector. Adjusted OR for thyroid versus parathyroid operation was 0.94 (95% CI, 0.67-1.31). Adjusted OR for operation in the VA versus private sector was 1.25 (95% CI, 0.87-1.78). Conclusions: Overall rates of mortality and any morbidity were low and consistent with previous reports. Based on adjusted OR, there was no significant difference in outcomes for thyroid versus parathyroid operation. Similarly, there was no apparent significant difference in surgical outcomes between the VA and private-sector groups after risk adjustment.
AB - Background: There is increasing interest in surgical outcomes. The Patient Safety in Surgery (PSS) Study database was examined about thyroid and parathyroid procedures to determine risk factors for adverse outcomes and outcomes rates. Relative outcomes performance for the Veterans Affairs (VA) and private-sector populations was compared after risk adjustment. Study Design: Preoperative, operative, and postoperative data were analyzed for 7,082 patients: 2,814 VA patients and 4,268 private sector patients. Prevalence of risk or process factors was described. Occurrence rates and unadjusted odds ratios (OR) for adverse outcomes were calculated. Stepwise multiple logistic regressions were performed to model the impact of various factors on outcomes and to calculate the adjusted OR for any adverse event for the VA population compared with the private sector. Results: Overall mortality rate was 0.35% and 0.60% in the VA and 0.19% in the private sector. Overall rate of any adverse outcomes was 2.90% and 4.48% in the VA and 1.97% in the private sector. Adjusted OR for thyroid versus parathyroid operation was 0.94 (95% CI, 0.67-1.31). Adjusted OR for operation in the VA versus private sector was 1.25 (95% CI, 0.87-1.78). Conclusions: Overall rates of mortality and any morbidity were low and consistent with previous reports. Based on adjusted OR, there was no significant difference in outcomes for thyroid versus parathyroid operation. Similarly, there was no apparent significant difference in surgical outcomes between the VA and private-sector groups after risk adjustment.
UR - http://www.scopus.com/inward/record.url?scp=34249322238&partnerID=8YFLogxK
U2 - 10.1016/j.jamcollsurg.2007.02.073
DO - 10.1016/j.jamcollsurg.2007.02.073
M3 - Article
C2 - 17544080
AN - SCOPUS:34249322238
SN - 1072-7515
VL - 204
SP - 1222
EP - 1234
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 6
ER -