Retained surgical items after abdominal and pelvic surgery: Incidence, trend and predictors- observational study.

INTRODUCTION: Surgical retained items (RSIs) are associated with increase in perioperative morbidity and mortality. We used a large national database to investigate the incidence, trends and possible predictors for RSIs after major abdominal and pelvic procedures.

METHODS: The nationwide inpatient sample data were queried to identify patients who underwent major abdominal and pelvic procedures and discharged with secondary ICD-9-CM diagnosis code of (998.44 and 998.7). McNemar's tests and conditional logistic regression analyses of a 1:1 matched sample were conducted to explore possible predictive factors for RSI.

RESULTS: RSI incidence rate was 13 in 100,000 cases-years from 2007 to 2011 after major abdominal and pelvic procedures. RSI incidence remained steady over the five-year study period. Rural hospitals and elective procedures were associated with a higher RSI incidence rate [(OR 1.391, 95% CL 1.056-1.832), p = 0.019] and [(OR 1.775, 95%CL 1.501-2.098), p < 0.001] respectively.

CONCLUSIONS: Our study was able to add more to the epidemiological perspective and the risk profile of retained surgical items in abdominal and pelvic surgery. Surgical cases associated with these factors may need further testing to rule out RSI.