FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2224965549> ?p ?o ?g. }

• W2224965549 abstract "In March 2015, The New York Times reported on a patient in her 90s who underwent valve replacement surgery complicated by progressive deterioration.1 The surgeons were optimistic that she would recover, recommended aggressive care, and deferred palliative care options until postoperative day 30, by which time the patient had developed sepsis with multiorgan failure. She died on postoperative day 31. Did the surgeons purposefully delay death beyond 30 days? Concerns have been raised that public disclosure of 30-day postoperative mortality as a metric of surgical quality might result in either reluctance of surgeons to operate on high-risk patients or delaying death until after 30 days. In this issue of JAMA Surgery, Smith and colleagues2 look at 3 years of surgerywithin theVeteransHealthAdministration (VHA) and present data on 30-, 90-, 180-, and 365-day overall survival. The authors calculated survival by deciles of risk for mortality. In all surgical specialties, survival at 30 dayswas associatedwithpatient risksandcorrelatedwellwith subsequent survival up to 1 year. Mortality between postoperative days 25 and35by riskdecile showednoevidenceofdelayeddeath.The authorsconcludedthat therewasnocompromise inpatientcare tomeet the 30-daymortality metric. Thus, the 30-daymortalitymetric was validated as a standard surgical metric. The authors2 acknowledge that their study could not discern any unethical behavior that might delay care or treatment to meet the 30-day mortality metric. In addition, this study did not measure whether surgeons refused to operate on high-risk patients to avoid a death at 30 days. The VHA has taken the lead in measuring quality of surgical care throughtheNationalSurgicalQualityProgram,which was later adopted by the American College of Surgeons. The programs didwell over time and,within the VHA system, improvedmortality from3.2% in 1994 to 1.0% in2014.3 TheVHA hasalso taken the lead in implementingpatient-centeredcare, but availablemetrics donot account for patient-informeddecisions that can adversely affect those metrics. As advocated by Schwarze et al,4 it is time to align quality metrics with outcomes that patients value. Quality metrics, such as 30-day mortality, are now used in publicreporting social media and pay-for-performance programs, resulting in care that is now metrics driven rather than patient centered. We can and should realign patient care with metrics that matter through well-established and developed processes of care.5 Quality metrics initially developed to improve systems and processes of care should continue to be refined to take into consideration the care that matters to patients and is of value to both patients and the health care system." @default.
• W2224965549 created "2016-06-24" @default.
• W2224965549 creator A5005319539 @default.
• W2224965549 date "2016-05-01" @default.
• W2224965549 modified "2023-09-27" @default.
• W2224965549 title "Validation of the 30-Day Postoperative Mortality Standard and Its Relevance" @default.
• W2224965549 cites W1888272674 @default.
• W2224965549 cites W2148437321 @default.
• W2224965549 cites W2232091753 @default.
• W2224965549 doi "https://doi.org/10.1001/jamasurg.2015.4889" @default.
• W2224965549 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/26746566" @default.
• W2224965549 hasPublicationYear "2016" @default.
• W2224965549 type Work @default.
• W2224965549 sameAs 2224965549 @default.
• W2224965549 citedByCount "0" @default.
• W2224965549 crossrefType "journal-article" @default.
• W2224965549 hasAuthorship W2224965549A5005319539 @default.
• W2224965549 hasConcept C141071460 @default.
• W2224965549 hasConcept C162324750 @default.
• W2224965549 hasConcept C176217482 @default.
• W2224965549 hasConcept C194828623 @default.
• W2224965549 hasConcept C21547014 @default.
• W2224965549 hasConcept C2778384902 @default.
• W2224965549 hasConcept C61434518 @default.
• W2224965549 hasConcept C71924100 @default.
• W2224965549 hasConceptScore W2224965549C141071460 @default.
• W2224965549 hasConceptScore W2224965549C162324750 @default.
• W2224965549 hasConceptScore W2224965549C176217482 @default.
• W2224965549 hasConceptScore W2224965549C194828623 @default.
• W2224965549 hasConceptScore W2224965549C21547014 @default.
• W2224965549 hasConceptScore W2224965549C2778384902 @default.
• W2224965549 hasConceptScore W2224965549C61434518 @default.
• W2224965549 hasConceptScore W2224965549C71924100 @default.
• W2224965549 hasLocation W22249655491 @default.
• W2224965549 hasLocation W22249655492 @default.
• W2224965549 hasOpenAccess W2224965549 @default.
• W2224965549 hasPrimaryLocation W22249655491 @default.
• W2224965549 isParatext "false" @default.
• W2224965549 isRetracted "false" @default.
• W2224965549 magId "2224965549" @default.
• W2224965549 workType "article" @default.