Study identifies risk factors for foreign bodies left in children after surgery, outcomes

Nov 15, 2010

Few children leave surgery with a foreign body left inside them, but such events appear most likely to occur during gynecologic operations, according to a report in the November issue of Archives of Surgery, one of the JAMA/Archives journals. This surgical error was associated with longer hospital stays and increased costs, but not with an increased risk of death.

The Institute of Medicine identified as a significant contributor to costs, illness and death in a report issued in 1999, according to background information in the article. In response, the Agency for Healthcare Research and Quality (AHRQ) developed a set of Indicators designed to identify adverse events in the inpatient setting. Researchers soon questioned whether these indicators were relevant to the pediatric population. In 2006, AHRQ developed a second set of indicators specifically for children, the Pediatric Quality Indicators.

When linked to hospital administrative databases, these indicators can identify patient safety and other errors that occur in children. Melissa Camp, M.D., M.P.H., and colleagues at Johns Hopkins Children's Center, Baltimore, used this type of linkage to analyze data on 1.9 million hospitalized children from two databases between 1988 and 2005. Of these, 413 children (0.02 percent) were found to have foreign bodies left during a procedure. These patients were matched to three controls each, for a total of 1,227 controls.

Compared with all other types of procedures—including ear, nose, throat, heart and chest, orthopedic and spine surgeries—gynecology surgical procedures had the highest likelihood of having a foreign body left during a procedure. Average length of hospital stay was increased for children experiencing this complication compared with controls (seven days vs. three days) and total hospital charges were also higher ($89,415 vs. $40,503).

Of the 17 patients who had a foreign body left during a gynecologic procedure, 15 had ovarian cyst or cancer-related procedures, one had a cesarean section and one had a procedure for pelvic adhesions (internal scars).

Additional studies should more clearly identify specific procedures associated with leaving foreign bodies in children, the authors note. "This will have implications for providers performing these procedures, because awareness of a higher risk could prompt the need for greater attention to prevent the occurrence of an adverse event," the authors conclude. "Moreover, the results of this analysis are relevant to the ongoing and evolving process of implementing standardized national outcomes measures for pediatric surgical operations."

Explore further: Majority of primary care physicians find that medical imaging improves patient care

More information: Arch Surg. 2010;145[11]:1085-1090

add to favorites email to friend print save as pdf

Related Stories

Airway obstructions uncommon but deadly in children

Apr 19, 2010

Cases of foreign bodies obstructing the airways of young children occur infrequently, but the death rate from such events is high, according to a report in the April issue of Archives of Otolaryngology-Head & Neck Surgery.

Recommended for you

Is head CT overused in emergency departments?

20 hours ago

Less than 7.1% of patients presenting to the emergency department with dizziness and 6.4% complaining of syncope or near-syncope benefited from head CT say researchers at Kaiser Foundation Hospital in Honolulu. The use of ...

Medical radiation may be reduced to one-sixth

23 hours ago

One of this century's most significant mathematical discoveries may reduce the number of measuring points to one-sixth of the present level. This means reduced exposure to radiation and faster medical imaging ...

The 'fifth taste,' umami, could be beneficial for health

Jan 25, 2015

The umami taste could have an important and beneficial role in health, according to research published in the open access journal Flavour. The journal's special series of articles 'The Science of Taste' also finds that ' ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.