Abstract
BackgroundIn spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery.MethodsAn observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis.ResultsThe prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”.ConclusionsThe “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies.
Highlights
In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events
The aim of this study is to validate a set of predictive “triggers” for adverse events in patients operated in General surgery and gastrointestinal surgery departments
The sample was calculated randomly according to an estimated probability of 90% for detection of adverse events [2], with an estimated population of 80,000 patients, a 95% confidence interval and precision of 0.02
Summary
In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Identification of adverse events is relevant for patient safety. Surgical units are the areas with the highest frequency of adverse events [7]. They are related to 1.9% to 3.6% of adverse events in patients admitted to hospital, which. Pérez Zapata et al Patient Safety in Surgery (2022) 16:7 represents 46% to 65% of all adverse events in hospitalization [3, 8, 9]. Since the publication of the Harvard Medical Practice Study (HMPS) [9], the retrospective methodology to review adverse events has been the most commonly used
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