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Study: Overlapping Surgeries Are Riskier After All

By Steven Porter  
   December 18, 2017

Latest study is first to find heightened rate of complications among double-booked operations.

In the two years since The Boston Globe’s Spotlight team published its investigation into patient safety concerns arising from concurrent surgeries at Massachusetts General Hospital, researchers have published numerous studies that show no increase in harm to patients when operations overlap.

This month, however, JAMA Internal Medicine published a study online that seems to support the Globe’s line of questioning, which prompted government inquiries and a review by the American College of Surgeons, not to mention heightened public awareness of the practice.

The new study found that complication rates were higher among overlapping hip surgeries than operations done one at a time and that longer durations of overlap were associated with increased risk.

“Currently, this seems to be the first study to show an adverse effect from the practice of overlapping surgery,” Alan Zhang, MD, an orthopedic surgeon at the University of California San Francisco, wrote in commentary released with the findings. “Prior studies, including those performed at my institution, have found no association between patient complications and overlapping surgery.”

One thing that differentiates this latest study from earlier reports on the topic is its size, as MinnPost’s Susan Perry noted. The study reviewed records from more than 90,000 hip replacements across some 75 hospitals and tracked patients for a full year after surgery.

“The size, the numbers, the multiple institutions, and the long-term follow-up dwarf any of those other studies,” James Rickert, MD, an orthopedic surgeon and president of the Society for Patient Centered orthopedics, told the Globe.

Medicare billing rules permit overlapping surgeries, as long as the attending surgeon is there for the critical moments, so it’s up to hospitals to decide whether they will allow the practice, as Kaiser Health News reported earlier this year.

Steven Porter is editor at HealthLeaders.


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