Analysis of the causes and effects of delay before diagnosis using surgical mortality data

North, J. B., Blackford, F. J., Wall, D., Allen, J., Faint, S., Ware, R. S. and Rey-Conde, T. (2013) Analysis of the causes and effects of delay before diagnosis using surgical mortality data. British Journal of Surgery, 100 3: 419-425. doi:10.1002/bjs.8986


Author North, J. B.
Blackford, F. J.
Wall, D.
Allen, J.
Faint, S.
Ware, R. S.
Rey-Conde, T.
Title Analysis of the causes and effects of delay before diagnosis using surgical mortality data
Journal name British Journal of Surgery   Check publisher's open access policy
ISSN 0007-1323
1365-2168
Publication date 2013-02
Year available 2012
Sub-type Article (original research)
DOI 10.1002/bjs.8986
Volume 100
Issue 3
Start page 419
End page 425
Total pages 7
Place of publication Chichester, West Sussex, United Kingdom
Publisher John Wiley & Sons
Collection year 2013
Language eng
Formatted abstract
Background: The aim of the study was to assess the causes and effects of delay in diagnosis in surgical patients who died in 20 public hospitals participating in the Queensland Audit of Surgical Mortality (QASM) in Australia.
Methods: This was a retrospective cross-sectional analysis (June 2007 to December 2011) of deaths reported to QASM. Deaths were assigned to one of two groups (no delay or delay in diagnosis). Logistic regression was used to compare the association of delay with surgical complications, both overall and by surgical specialty.
Results: A total of 3139 deaths were reported. Diagnostic delay was reported in 293 (9·3 per cent). The primary cause of delay was attributed to diagnostic support services (41·7 per cent). Some 174 (13·8 per cent) of 1259 general (gastrointestinal) surgery patients experienced delayed diagnosis. Delay across all surgical specialties was associated with an increased risk of unplanned return to theatre (odds ratio (OR) 1·77, 95 per cent confidence interval 1·24 to 2·52), of being treated in intensive care (OR 1·71, 1·15 to 2·54) and of postoperative complications (OR 1·39, 1·05 to 1·85).
Conclusion: General (gastrointestinal) surgery patients who experienced delayed diagnosis were at increased risk of postoperative complications.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 6 DEC 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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Created: Wed, 16 Jan 2013, 13:28:20 EST by Geraldine Fitzgerald on behalf of School of Public Health