PT  - JOURNAL ARTICLE
AU  - Samuel Minor
AU  - Laura Allen
AU  - Michael T. Meschino
AU  - Rahima Nenshi
AU  - Rardi van Heest
AU  - Fady Saleh
AU  - Sandy Widder
AU  - Paul T. Engels
AU  - Emilie Joos
AU  - Neil G. Parry
AU  - Patrick B. Murphy
AU  - Chad G. Ball
AU  - Morad Hameed
AU  - Kelly N. Vogt
ED  - ,
TI  - Failure to rescue in emergency general surgery in Canada
AID  - 10.1503/cjs.008820
DP  - 2022 Mar 22
TA  - Canadian Journal of Surgery
PG  - E215--E220
VI  - 65
IP  - 2
4099  - http://canjsurg.ca/content/65/2/E215.short
4100  - http://canjsurg.ca/content/65/2/E215.full
SO  - CAN J SURG2022 Mar 22; 65
AB  - Background: The risk of death after a postoperative complication — known as failure to rescue (FTR) — has been proposed to be superior to traditional benchmarking outcomes, such as complication and mortality rates, as a measure of system quality. The purpose of this study was to identify the current FTR rate in emergency general surgery (EGS) centres across Canada. We hypothesized that substantial variability exists in FTR rates across centres.Methods: In this multicentre retrospective cohort study, we performed a secondary analysis of data from a previous study designed to evaluate operative intervention for nonappendiceal, nonbiliary disease by 6 EGS services across Canada (1 in British Columbia, 1 in Alberta, 3 in Ontario and 1 in Nova Scotia). Patients underwent surgery between Jan. 1 and Dec. 31, 2014. We conducted univariate analyses to compare patients with and without complications. We performed a sensitivity analysis examining the mortality rate after serious complications (Clavien–Dindo score 3 or 4) that required a surgical intervention or specialized care (e.g., admission to intensive care unit).Results: A total of 2595 patients were included in the study cohort. Of the 206 patients who died within 30 days, 145 (70.4%) experienced a complication before their death. Overall, the mortality rate after any surgical complication (i.e., FTR) was 16.0%. Ranking of sites by the traditional outcomes of complication and mortality rates differed from the ranking when FTR rate was included in the assessment.Conclusion: There was variability in FTR rates across EGS services in Canada, which suggests that there is opportunity for ongoing quality-improvement efforts. This study provides FTR benchmarking data for Canadian EGS services.