Failure to rescue in the surgical patient: A review

Marc Lafonte, Jenny Cai, Matthew E. Lissauer

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Purpose of reviewEvaluating patient outcomes is essential in a healthcare environment focused on quality. Mortality after surgery has been considered a useful quality metric. More important than mortality rate, failure to rescue (FTR) has emerged as a metric that is important and may be improveable. The purpose of this review is to define FTR, describe patient and hospital level factors that lead to FTR, and highlight possible solutions to this problem.Recent findingsFTR is defined as a death following a complication. Depending on the patient population, FTR rates vary from less than 1% to over 40%. Numerous patient factors including frailty, congestive heart failure (CHF), renal failure, serum albumin <3.5, COPD, cirrhosis, and higher ASA class may predispose patients to FTR. Hospital factors including technology, teaching status, increased nurse-to-patient ratios, and closed ICUs may help reduce FTR. More difficult to measure variables, such as hospital culture and teamwork may also influence FTR rates. Early warning systems may allow earlier identification of the deteriorating patient.SummaryFTR is a major clinical concern and efforts aimed at optimizing patient and hospital factors, culture and communication, as well as early identification of the deteriorating patient may improve FTR rate.

Original languageEnglish (US)
Pages (from-to)706-711
Number of pages6
JournalCurrent Opinion in Critical Care
Volume25
Issue number6
DOIs
StatePublished - Dec 1 2019

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Keywords

  • failure-to-rescue
  • mortality rates
  • patient safety
  • quality of care
  • surgery

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