Risk assessment in ginecology and obstetrics in Sicily: an approach based on Wolff's Criteria

Ann Ig. 2013 Mar-Apr;25(2):137-44. doi: 10.7416/ai.2013.1915.

Abstract

Objectives: To apply Wolff's Criteria to hospital discharge records (HDR) in order to detect adverse events worthy of further study.

Methods: Gynecology and Obstetrics Units of three Sicilian hospitals were considered and HDR regarding ordinary and day hospital admissions in 2008 were collected. A matched case-control study was designed, by random selection of 10 controls at maximum for each case. Matching was performed on the variables age and speciality of admission (gynecology or obstetrics).

Results: Out of a total of 7011 HDR examined, 114 cases were identified with Wolff's Criteria. Multivariate analysis confirmed a statistically significant association with the origin of admission, diagnosis at the acceptance and length of stay: there was a decreased risk of Wolff's event in patients having urgent admission compared to elective (OR = 0.47, 95% CI = [0.28-0.78]), an increased risk in patients reporting tumor (OR = 5:41, 95 % CI [1.89-15.47]) and other causes (OR = 2.16, 95% CI [1.10-4.24]) compared to delivery diagnosis at acceptance and in patients whose length of stay was more than 6 days (OR = 23.17, 95% CI = [12.56-42.7]) compared to less or equal than 3 days

Conclusion: Wolff's Criteria can be applied for the analysis of clinical risk in hospitals with different structural characteristics, on condition that the HDR database is complete and good quality.

MeSH terms

  • Ambulatory Care / statistics & numerical data
  • Case-Control Studies
  • Delivery, Obstetric / statistics & numerical data
  • Emergencies / epidemiology
  • Female
  • Genital Neoplasms, Female / epidemiology
  • Gynecologic Surgical Procedures / statistics & numerical data
  • Hospital Mortality
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Italy
  • Length of Stay / statistics & numerical data
  • Obstetrics and Gynecology Department, Hospital / statistics & numerical data*
  • Patient Discharge / statistics & numerical data*
  • Patient Readmission / statistics & numerical data
  • Patient Safety / standards
  • Patient Transfer / statistics & numerical data
  • Pregnancy
  • Prevalence
  • Quality Improvement
  • Reoperation / statistics & numerical data
  • Risk Assessment / methods*
  • Risk Assessment / standards
  • Risk Factors
  • Risk Management / standards