Artigo publicado na revista Neurosurgery de Abril de 2013 por Jay Vaccani sobre a incidência de neurocirurgias realizadas do lado errado. A incidência de craniotomias do lado errado chega de 2 a 3 por 10.000 nos Estados Unidos.
Abstract
BACKGROUND: Although exceedingly rare, wrong-site surgery (WSS)
remains a persistent problem in the United States. The incidence is thought to
be 2 to 3 per 10 000 craniotomies and about 6 to 14 per 10 000 spine surgeries.
In July 2004, the Joint Commission mandated the Universal Protocol (UP) for all
accredited hospitals.
OBJECTIVE: To assess the effect of UP implementation on the incidence
of neurosurgical WSS at the University of Illinois College of Medicine at
Peoria/Illinois Neurological Institute.
METHODS: The Morbidity and Mortality Database in the Department of
Neurosurgery was reviewed to identify all recorded cases of WSS since 1999. This
was compared with the total operative load (excluding endovascular procedures)
of all attending neurosurgeons to determine the incidence of overall WSS. A
comparison was then made between the incidences before and after UP
implementation.
RESULTS: Fifteen WSS events were found with an overall incidence of
0.07% and Poisson 95% confidence interval of 8.4 to 25. All but one of these
were wrong-level spine surgeries (14/15). There was only 1 recorded case of
wrong-side surgery and this occurred after implementation of the UP. A
statistically greater number of WSS events occurred before (n = 12) in
comparison with after (n = 3) UP implementation (P < .001).
CONCLUSION: A statistically significant reduction in overall WSS was
seen after implementation of the UP. This reduction can be attributed to less
frequent wrong-level spine surgery. There was no case of wrong procedure or
patient surgery and the 1 case of wrong-side surgery occurred after UP
implementation.
ABBREVIATIONS: JC, Joint Commission
UP, Universal Protocol
WSS, wrong-site surgery
Author Information
Department of Neurosurgery, Illinois Neurological Institute, University of Illinois College of Medicine in Peoria, Peoria, Illinois
Correspondence: Jay A. Vachhani, MD, Department of Neurosurgery, Illinois Neurological Institute, University of Illinois College of Medicine in Peoria, 530 NE Glen Oak Ave, Peoria, IL 61637. E-mail: jay.vachhani@gmail.com
Received May 24, 2012
Accepted December 04, 2012
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