B. K. Patel1, R. Dev1, K. Zhang1, J. Mccauley1, J. Luo3, Y. Zhang2,3, K. Y. Pei1 1Texas Tech University Health Sciences Center,Surgery,Lubbock, TX, USA 2Yale School of Medicine,Surgical Outcomes And Epidemiology,New Haven, CT, USA 3Yale School of Public Health,Environmental Health Sciences,New Haven, CT, USA
Introduction:
Intraoperative safety is a top priority among hospitals across the country and significant resources are allocated to preventing retained objects intraoperatively. Despite such efforts including liberal intraoperative safety checks, instrument counts, and radiofrequency scanning, a small percentage of patients unfortunately still require additional surgery to extract retained foreign objects. It is unknown whether the ACS NSQIP database actually reports foreign objects and the purpose of this study is to examine some characteristics common to these events.
Methods:
The ACS NSQIP database was queried for patients with experienced a retained object intraoperatively (identified by ICD 9 998.4 ICD 10 T81.509A) from 2005 to 2016. Trends information was evaluated as percentages of total procedures performed from NSQIP participating hospitals. Standard descriptive statistics was analyzed and characteristics were reported as medians with quartiles or means where appropriate.
Results:
A total of 236 cases were identified and included for analysis. Among NSQIP participating hospitals, incidence of retained foreign objects remain largely unchanged averaging 19 cases per year, with the exception of 2016 where only 2 events were noted. All patients required reoperation for retrieval of object. The 10 most frequent procedures required as a result of foreign object retention involve abdominal procedures with the majority of secondary procedures involving extraction of retained surgical instruments from the abdomen (Table 1). Mean operative time was 79.16 minutes with SD of 70.19, majority were non-emergent, and majority were ASA Class 2-3.
Conclusion:
Unintended retained foreign objects during surgery is potentially catastrophic. It is notable that ACS NSQIP is transparent and reports such events. Contrary to published literature, patients who suffered retention were not necessarily the most complex medically and did not have the long operative times.
