{"title":"大手术后残留异物:趋势、风险因素及相关结果","authors":"Barzin Badiee , Saad Mallick MD , Konmal Ali , Melissa Justo MD , Sona Mahrokhi MD , Peyman Benharash MD","doi":"10.1016/j.surg.2025.109513","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Retained foreign bodies are rare complications of surgical practice that are associated with adverse events and increased health care costs. While previous work has reported on the incidence of retained foreign bodies, updated national data evaluating contemporary trends as well as risk factors and associated outcomes remain limited.</div></div><div><h3>Methods</h3><div>The 2018–2022 National Inpatient Sample was used to identify all hospitalizations entailing major cardiac, gastrointestinal, genitourinary, neurosurgical, orthopedic, thoracic, and vascular operations. Patients were categorized based on the presence of a retained foreign body. Multivariable regression models were developed to evaluate the association of retained foreign bodies with risk factors and outcomes of interest.</div></div><div><h3>Results</h3><div>Of an estimated 26,333,269 surgical hospitalizations, 4,570 (0.017%) carried a concomitant diagnosis for a retained foreign body. The proportion of cases with a retained foreign body decreased from 1/5,400 to 1/6,000 cases from 2018 to 2022 (<em>P</em> <.001). Relative to cardiac operations, gastrointestinal (adjusted odds ratio, 2.26; 95% confidence interval, 1.63–3.13), thoracic (adjusted odds ratio; 3.22, 95% confidence interval, 2.05–5.10), vascular (adjusted odds ratio, 2.78; 95% confidence interval, 1.89–4.10), and multicavity (adjusted odds ratio, 2.10; 95% confidence interval, 1.50–2.93) operations were associated with greater odds of retained foreign body occurrence. Moreover, treatment at hospitals with small-bed size was linked to reduced likelihood of retained foreign body event (adjusted odds ratio, 0.79; 95% confidence interval, 0.65–0.95), whereas care at hospitals in the Western United States was associated with increased odds (adjusted odds ratio, 1.29; 95% confidence interval, 1.05–1.59). Retained foreign body occurrence was also associated with a greater risk of complications, prolonged hospital stay, and increased hospitalization costs.</div></div><div><h3>Conclusion</h3><div>Despite a declining incidence of retained foreign bodies, further efforts focused on standardized safety protocols and technological solutions are needed to achieve zero-incidence prevention.</div></div>","PeriodicalId":22152,"journal":{"name":"Surgery","volume":"185 ","pages":"Article 109513"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Retained foreign bodies after major operations: Trends, risk factors, and associated outcomes\",\"authors\":\"Barzin Badiee , Saad Mallick MD , Konmal Ali , Melissa Justo MD , Sona Mahrokhi MD , Peyman Benharash MD\",\"doi\":\"10.1016/j.surg.2025.109513\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Retained foreign bodies are rare complications of surgical practice that are associated with adverse events and increased health care costs. While previous work has reported on the incidence of retained foreign bodies, updated national data evaluating contemporary trends as well as risk factors and associated outcomes remain limited.</div></div><div><h3>Methods</h3><div>The 2018–2022 National Inpatient Sample was used to identify all hospitalizations entailing major cardiac, gastrointestinal, genitourinary, neurosurgical, orthopedic, thoracic, and vascular operations. Patients were categorized based on the presence of a retained foreign body. Multivariable regression models were developed to evaluate the association of retained foreign bodies with risk factors and outcomes of interest.</div></div><div><h3>Results</h3><div>Of an estimated 26,333,269 surgical hospitalizations, 4,570 (0.017%) carried a concomitant diagnosis for a retained foreign body. The proportion of cases with a retained foreign body decreased from 1/5,400 to 1/6,000 cases from 2018 to 2022 (<em>P</em> <.001). Relative to cardiac operations, gastrointestinal (adjusted odds ratio, 2.26; 95% confidence interval, 1.63–3.13), thoracic (adjusted odds ratio; 3.22, 95% confidence interval, 2.05–5.10), vascular (adjusted odds ratio, 2.78; 95% confidence interval, 1.89–4.10), and multicavity (adjusted odds ratio, 2.10; 95% confidence interval, 1.50–2.93) operations were associated with greater odds of retained foreign body occurrence. Moreover, treatment at hospitals with small-bed size was linked to reduced likelihood of retained foreign body event (adjusted odds ratio, 0.79; 95% confidence interval, 0.65–0.95), whereas care at hospitals in the Western United States was associated with increased odds (adjusted odds ratio, 1.29; 95% confidence interval, 1.05–1.59). Retained foreign body occurrence was also associated with a greater risk of complications, prolonged hospital stay, and increased hospitalization costs.</div></div><div><h3>Conclusion</h3><div>Despite a declining incidence of retained foreign bodies, further efforts focused on standardized safety protocols and technological solutions are needed to achieve zero-incidence prevention.</div></div>\",\"PeriodicalId\":22152,\"journal\":{\"name\":\"Surgery\",\"volume\":\"185 \",\"pages\":\"Article 109513\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-06-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0039606025003654\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0039606025003654","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Retained foreign bodies after major operations: Trends, risk factors, and associated outcomes
Background
Retained foreign bodies are rare complications of surgical practice that are associated with adverse events and increased health care costs. While previous work has reported on the incidence of retained foreign bodies, updated national data evaluating contemporary trends as well as risk factors and associated outcomes remain limited.
Methods
The 2018–2022 National Inpatient Sample was used to identify all hospitalizations entailing major cardiac, gastrointestinal, genitourinary, neurosurgical, orthopedic, thoracic, and vascular operations. Patients were categorized based on the presence of a retained foreign body. Multivariable regression models were developed to evaluate the association of retained foreign bodies with risk factors and outcomes of interest.
Results
Of an estimated 26,333,269 surgical hospitalizations, 4,570 (0.017%) carried a concomitant diagnosis for a retained foreign body. The proportion of cases with a retained foreign body decreased from 1/5,400 to 1/6,000 cases from 2018 to 2022 (P <.001). Relative to cardiac operations, gastrointestinal (adjusted odds ratio, 2.26; 95% confidence interval, 1.63–3.13), thoracic (adjusted odds ratio; 3.22, 95% confidence interval, 2.05–5.10), vascular (adjusted odds ratio, 2.78; 95% confidence interval, 1.89–4.10), and multicavity (adjusted odds ratio, 2.10; 95% confidence interval, 1.50–2.93) operations were associated with greater odds of retained foreign body occurrence. Moreover, treatment at hospitals with small-bed size was linked to reduced likelihood of retained foreign body event (adjusted odds ratio, 0.79; 95% confidence interval, 0.65–0.95), whereas care at hospitals in the Western United States was associated with increased odds (adjusted odds ratio, 1.29; 95% confidence interval, 1.05–1.59). Retained foreign body occurrence was also associated with a greater risk of complications, prolonged hospital stay, and increased hospitalization costs.
Conclusion
Despite a declining incidence of retained foreign bodies, further efforts focused on standardized safety protocols and technological solutions are needed to achieve zero-incidence prevention.
期刊介绍:
For 66 years, Surgery has published practical, authoritative information about procedures, clinical advances, and major trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons.