A recent shift from inpatient to outpatient surgery in urological procedures may have led to an increase in preventable deaths from related complications.
Over the past 20 years measures to improve healthcare have expanded in the context of surgical procedures, leading to a decrease in death event though more patients now enter surgery, Wiley reported. This, however, has not been true for urology patients.
"Unfortunately, we saw an opposite trend in urology, wherein in-hospital surgery rates fell, mortality overall stayed stable, and failure to rescue rates-which refer to deaths following complications that were potentially recognizable or preventable-went up," said Dr. Sammon, DO, of the Henry Ford Health System's Vattikuti Urology Institute in Detroit.
To make their findings the researchers looked at discharge records of patients who underwent urologic surgery in the United States between the years of 1998 and 2010. A total of 7,725,736 surgeries requiring hospitalization were performed over that period of time. Admission for urologic surgery decreased by 0.63 percent per year; during this time the odds of dying following urologic surgery decreased but the odds of dying following complications that were potentially preventable rose 1.5 percent per year.
The researchers also observed a major shift in the type of patients who were admitted for urological surgeries. In the past generally healthy patients were usually admitted for low-risk procedures, but when outpatient procedures became more popular the population who were admitted to the hospital became generally sicker.
"Consequently, urological surgeons and ancillary staff members need to recognize that the contemporary cohort of urology inpatients is generally at higher risk of complications and consequently failure to rescue mortality," Dr. Sammon said. Therefore, a "heightened awareness of early signs of complications may help reduce mortality rates after urologic surgery."
The study was published in a recent edition of BJU International.
