THE IMPACT OF THE IMPLEMENTATION OF QUALITY IMPROVEMENT INITIATIVES ON MORTALITY RATE AFTER POSTOPERATIVE PERITONITIS IN ONCOLOGICAL DIGESTIVE SURGERY

Abstract

Background: Postoperative peritonitis (POP) is a nosocomial form of peritonitis and it is defined as an infection of the abdominal cavity complicating a surgical intervention. This study aims to analyze the impact of quality improvement initiatives on mortality rate after postoperative peritonitis (failure to rescue). Methods: This study included patients treated between January 2016 and December 2020. The data collected during this period included 977 patients who underwent curative resection for digestive cancer. Our intervention consists of the implementation of three quality improvement initiatives: Early detection protocol for anastomotic leakage, daily morning staff and morbimortality reviews (MMR). Our study period was divided into two periods (before and after the intervention). The endpoints were to improve failure to rescue(FTR) through the analysis of the impact these measures have on mortality rate during the second period. Results: Our cross-sectional, retrospective study included 977 patients, where 66 patients had postoperative peritonitis. Concerning patients' comorbidities, none were significant except for smoking, where we find a higher percentage in the first period compared to the second period (35% vs 3.84%; p<0.05). Among these 66 POPs, 6.75% of patients were observed during the first period versus 4.87% during the second period (p<0.05). There was a decrease of the mortality rate during the second period from 30% to 11.54% (p>0.05). Conclusion: This study has shown that the implementation of quality improvement initiatives is prone to improving FTR.