We read with interest the article by Birkmeyer et al,1 who assessed unplanned returns to the operating room (OR) as a quality indicator of a general surgery department. The authors point out that this may be an attractive and useful quality indicator because it is a relatively easy and inexpensive factor to identify with administrative and clinical data.
We conducted a study on the incidence of and risk factors for unplanned return to the OR in the vascular surgery department of Rouen University Hospital (Rouen, France) using the Diagnosis-Related Groups 1997 database. The first part of our study concerned the evaluation of this database's validity. During a 3-month period, the reporting and coding of surgical and anesthetic procedures for patients with unplanned returns to the OR were assessed using OR registers as the standard reference; 99 patients with a return to the OR and 438 patients without were included.
Ladner J, Torre JP, Watelet J, Czernichow P. The Validity of Unplanned Returns to the Operating Room as an Indicator of Quality of Hospital Care. Arch Surg. 2002;137(4):493. doi: