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dc.contributor.author
Sarnthein, Johannes
dc.contributor.author
Stieglitz, Lennart
dc.contributor.author
Clavien, Pierre-Alain
dc.contributor.author
Regli, Luca
dc.date.accessioned
2018-08-23T09:40:27Z
dc.date.available
2017-06-12T13:53:55Z
dc.date.available
2018-08-23T09:40:27Z
dc.date.issued
2016-09-26
dc.identifier.issn
1932-6203
dc.identifier.other
10.1371/journal.pone.0163154
en_US
dc.identifier.uri
http://hdl.handle.net/20.500.11850/121365
dc.identifier.doi
10.3929/ethz-b-000121365
dc.description.abstract
Background To improve the transparency of the local health care system, treatment cost was recently referenced to disease related groups. Treatment quality must be legally documented in a patient registry, in particular for the highly specialized treatments provided by neurosurgery departments. Methods In 2013 we have installed a patient registry focused on cranial neurosurgery. Surgeries are characterized by indication, treatment, location and other specific neurosurgical parameters. Preoperative state and postoperative outcome are recorded prospectively using neurological and sociological scales. Complications are graded by their severity in a therapy-oriented complication score system (Clavien-Dindo-Grading system, CDG). Results are presented at the monthly clinical staff meeting. Results Data acquisition compatible with the clinic workflow permitted to include all eligible patients into the registry. Until December 2015, we have registered 2880 patients that were treated in 3959 surgeries and 8528 consultations. Since the registry is fully operational (August 2014), we have registered 325 complications on 1341 patient discharge forms (24%). In 64% of these complications, no or only pharmacological treatment was required. At discharge, there was a clear correlation of the severity of the complication and the Karnofsky Performance Status (KPS, ρ = -0.3, slope -6 KPS percentage points per increment of CDG) and the length of stay (ρ = 0.4, slope 1.5 days per increment of CDG). Conclusions While the therapy-oriented complication scores correlate reasonably well with outcome and length of stay, they do not account for new deficits that cannot be treated. Outcome grading and complication severity grading thus serve a complimentary purpose. Overall, the registry serves to streamline and to complete information flow in the clinic, to identify complication rates and trends early for the internal quality monitoring and communication with patients. Conversely, the registry influences clinical practice in that it demands rigorous documentation and standard operating procedures.
en_US
dc.format
application/pdf
en_US
dc.language.iso
en
en_US
dc.publisher
Public Library of Science
en_US
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.title
A Patient Registry to Improve Patient Safety: Recording General Neurosurgery Complications
en_US
dc.type
Journal Article
dc.rights.license
Creative Commons Attribution 4.0 International
ethz.journal.title
PLoS ONE
ethz.journal.volume
11
en_US
ethz.journal.issue
9
en_US
ethz.journal.abbreviated
PLoS ONE
ethz.pages.start
e0163154
en_US
ethz.size
12 p.
en_US
ethz.version.deposit
publishedVersion
en_US
ethz.identifier.wos
ethz.identifier.scopus
ethz.identifier.nebis
006206116
ethz.publication.place
San Francisco, CA, USA
en_US
ethz.publication.status
published
en_US
ethz.date.deposited
2017-06-12T13:54:25Z
ethz.source
ECIT
ethz.identifier.importid
imp593654c51666d93131
ethz.ecitpid
pub:183461
ethz.eth
yes
en_US
ethz.availability
Open access
en_US
ethz.rosetta.installDate
2017-07-12T18:58:04Z
ethz.rosetta.lastUpdated
2018-08-23T09:40:31Z
ethz.rosetta.versionExported
true
ethz.COinS
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