Analysis finds unplanned returns to the OR overestimated

Editor's Note

In this single institution study, the most common reasons for unplanned return to the OR (uROR) were infection and hemorrhage. However, the researchers found that a large number of cases were incorrectly classified as uROR, when they were instead planned reoperations without adequate documentation.

Using uROR as reported by the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), clinical reviewers found a 4.3% unplanned return rate. Secondary review recategorized 64.7 % as “true uROR” (ie, infection 30.9% and bleeding 23.6%), and the rest as “false uROR” (ie, inadequate documentation 60.0% and not directly related to index procedure 16.7%).

The findings raise concerns about using NSQIP-identified uROR as a hospital quality metric, the authors say.

Unplanned return to the operating room (uROR) has been suggested as a hospital quality indicator. The purpose of this study was to determine reasons for uROR to identify opportunities for patient care improvement.