Academic Journal
Defining failure to rescue in emergency general surgery on the Eve of Centers for Medicare and Medicaid Services adoption: A scoping review.
| Τίτλος: | Defining failure to rescue in emergency general surgery on the Eve of Centers for Medicare and Medicaid Services adoption: A scoping review. |
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| Συγγραφείς: | Adeyemi O; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Kewalramani D; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ. Electronic address: dk1362@rwjms.rutgers.edu., Choron RL; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Teichman A; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Englert Z; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Kyaw C; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Cai J; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Goswami J; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Guven H; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Bharvad D; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Hanna JS; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Pitt HA; Division of Surgical Oncology, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ., Barie PS; Division of Trauma, Burns, Acute and Critical Care, Weill Cornell Medicine, New York, NY., Narayan M; Division of Acute Care Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ. |
| Πηγή: | Surgery [Surgery] 2026 Jul; Vol. 195, pp. 110249. Date of Electronic Publication: 2026 May 15. |
| Τύπος έκδοσης: | Scoping Review; Journal Article; Review |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Mosby Country of Publication: United States NLM ID: 0417347 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-7361 (Electronic) Linking ISSN: 00396060 NLM ISO Abbreviation: Surgery Subsets: MEDLINE |
| Imprint Name(s): | Publication: St. Louis, MO : Mosby Original Publication: St. Louis. |
| Ιατρικοί όροι (MeSH): | Failure to Rescue, Health Care*/statistics & numerical data , Postoperative Complications*/mortality , Postoperative Complications*/epidemiology , Surgical Procedures, Operative*/adverse effects , General Surgery*/standards, Centers for Medicare and Medicaid Services, U.S./standards ; Humans ; United States ; Acute Care Surgery ; Patient Safety |
| Περίληψη: | Background: Failure to rescue is an established surgical quality metric. The Centers for Medicare and Medicaid Services will replace Patient Safety Indicator-04 with a new failure-to-rescue measure in 2027. However, no standardized failure-to-rescue definition exists for emergency general surgery, and evidence supporting complication inclusion is lacking. We sought to examine whether failure-to-rescue definitions vary across emergency general surgery studies, how these definitions align with national frameworks, and characterize complication-mortality associations. Methods: A scoping review was conducted across 5 databases (2000-2025). Studies examining failure to rescue in adult emergency general surgery populations were included. Concordance between study-defined complications and established frameworks (Patient Safety Indicator-04, National Surgical Quality Improvement Program, and Centers for Medicare and Medicaid Services) was assessed. Odds ratios for complication-mortality associations were extracted. Results: Among 23 studies, failure-to-rescue definitions included a mean of 12 complications (range 7-19), with 38 unique complications identified. Framework concordance was low: Patient Safety Indicator-04 47%, National Surgical Quality Improvement Program 43%, and Centers for Medicare and Medicaid Services 18%. Of Centers for Medicare and Medicaid Services failure-to-rescue complications, 45% have never been studied in emergency general surgery. Failure-to-rescue rates ranged 4.9%-21.4% and higher among geriatric cohorts (11.6%-29.9%). Complication odds ratios were rarely reported (14.5%); among those, acute respiratory distress syndrome (odds ratio, 6.7), disseminated intravascular coagulopathy (odds ratio, 4.9), sepsis (odds ratio, 1.4-7.6), and pneumonia (odds ratio, 1.9-8.7) demonstrated the strongest mortality associations, whereas deep venous thrombosis and surgical site infections showed inverse associations. Conclusion: Emergency general surgery failure to rescue suffers from heterogeneity, as complications determining failure-to-rescue definitions vary widely. Emergency general surgery-specific validation or exclusion from the Centers for Medicare and Medicaid Services 2027 measure warrants consideration. (Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Conflict of Interest/Disclosures All authors reported no biomedical financial interests or potential conflicts of interest. |
| Entry Date(s): | Date Created: 20260515 Date Completed: 20260613 Latest Revision: 20260613 |
| Update Code: | 20260615 |
| DOI: | 10.1016/j.surg.2026.110249 |
| PMID: | 42139820 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1532-7361 |
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| DOI: | 10.1016/j.surg.2026.110249 |