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Retained Items (Sponges, Instruments) After Surgery Risk Factors

Purpose: To identify factors associated with an increased risk of surgical items being retained after surgery.

Description

The presence of certain risk factors can help identify a surgical patient who is more likely to have a retained sponge or instrument after surgery. A patient with one or more of these risk factors should be more closely monitored for signs that may be due to a retained surgical item. The authors are from Brigham and Women's Hospital and the Harvard School of Public Health.


Risk factors:

(1) operation performed as an emergency procedure

(2) unexpected change in the operation

(3) high body mass index (BMI)

 

Additional factors:

(4) failure to count sponges and instruments

 

Factor

Risk Ratio

95% CI

p Value

emergency surgery

8.8

2.4 – 31.9

< 0.001

unexpected change

4.1

1.4 – 12.4

0.01

high BMI (obesity)

1.1 per unit increment

1.0 – 1.2

0.01

counts performed

0.6

0.03 – 13.9

0.76

from Table 3, page 234

 

where:

• Doing a count of sponges and instruments did not prevent errors, but failure to do a count was associated with errors. According to Table 2, almost half of the cases with retained items had a count performed that was considered correct (30 out 54).


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Objective

ICD-10