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• W2107760042 abstract "You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-based Medicine & Outcomes1 Apr 201134 INCIDENCE OF PATIENT SAFETY INDICATORS (PSIS) FOR THREE MINIMALLY INVASIVE UROLOGIC SURGERIES: A FORMAL ANALYSIS OF THE NATIONAL INPATIENT SAMPLE (NIS) Elias Hyams, Zhaoyong Feng, Bruce Trock, and Brian Matlaga Elias HyamsElias Hyams Baltimore, MD More articles by this author , Zhaoyong FengZhaoyong Feng Baltimore, MD More articles by this author , Bruce TrockBruce Trock Baltimore, MD More articles by this author , and Brian MatlagaBrian Matlaga Baltimore, MD More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.097AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patient safety has become a central issue in healthcare quality; the development of Patient Safety Indicators (PSI) by the Agency for Healthcare Research and Quality (AHRQ) has brought new opportunities for patient safety research using administrative data. PSIs are designed to identify potentially preventable adverse events that compromise patient safety. At present, our understanding of PSIs in patients undergoing urologic surgery is limited, particularly with regard to minimally invasive surgeries. We examined the prevalence of PSIs in patients undergoing commonly performed laparoscopic/endourologic procedures: laparoscopic nephrectomy (LN), laparoscopic prostatectomy (LP), and percutaneous nephrolithotomy (PNL). METHODS We examined the 2008 Nationwide Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project, which contains discharge data from 1,056 hospitals in 42 states. Subjects were identified by ICD-9 coding: LN (5552, 5553 or 5554 with 5421 or 5451), LP (1742 with 605), and PNL (5504, and 5503 with 5521). PSIs were identified with AHRQ's proprietary software. Descriptive analyses were performed. RESULTS See Table 1 for PSI incidence among the 3 procedures. Subjects undergoing LP were significantly older than those undergoing LN or PNL. Mortality was significantly higher in LN (0.6%) compared with PNL (0%) and LP (0%) (p=0.0002). PSI PCNL(2179) N(2048) RP(2253) p-value Death in low mortality DRGs L0(0%) 0(0) 0(0) p=ns Pressure Ulcer 5(0.2) 4(0.2) 0(0) p=0.03(PCNL vs. RP) Death among Surgical Inpatients 0(0) 6(0.3) 0(0) p=0.01(LN vs. PCNL and RP) Foreign body left during procedure 1(0.05) 1(0.05) 0(0) p=ns Iatrogenic pneumothorax 4(0.18) 1(0.05) 0(0) p=ns Central Venous Catheter-related Bloodstream Infections 0(0) 0(0) 0(0) p=ns Postoperative hip fracture 0(0) 1(0.05) 0(0) p=ns Postoperative hemorrhage or hematoma 3(0.14) 5(0.24) 3(0.13) p=ns Postoperative physiologic and metabolic derangements 1(0.05) 6(0.29) 1(0.04) p=ns Postoperative respiratory failure 10(0.46) 13(0.63) 2(0.09) p=0.02(PCNL vs. RP); p=0.003(LN vs. RP) Postoperative pulmonary embolism or deep vein thrombosis 10(0.46) 13(0.63) 3(0.13) p=0.01(LNvs.RP) Postoperative sepsis 15(0.69) 1(0.05) 0(0) p=0.0006(PCNL vs. LN); p=0.0001(PCNLvs.RP) Postoperative wound dehiscence 0(0) 1(0.05) 0(0) p=ns Accidental puncture or laceration 19(0.87) 51(2.49) 13(0.58) p=0.0001(PCNLvs.LNandLP) Transfusion reaction 0(0) 0(0) 0(0) p=ns CONCLUSIONS The prevalence of PSIs among patients undergoing minimally invasive urologic surgeries is low. As patient safety continues to be an issue of importance in evaluating the quality of medical care, these data question the relevance of the AHRQ PSIs in assessing quality of care for urologic patients. Future efforts to identify more meaningful indicators of care quality for minimally invasive urologic surgery are welcome, as the urologic community continues to focus on the preventability of adverse events. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e13-e14 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elias Hyams Baltimore, MD More articles by this author Zhaoyong Feng Baltimore, MD More articles by this author Bruce Trock Baltimore, MD More articles by this author Brian Matlaga Baltimore, MD More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W2107760042 title "34 INCIDENCE OF PATIENT SAFETY INDICATORS (PSIS) FOR THREE MINIMALLY INVASIVE UROLOGIC SURGERIES: A FORMAL ANALYSIS OF THE NATIONAL INPATIENT SAMPLE (NIS)" @default.
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