Risk assessment in Ginecology and Obstetrics in Sicily: an approach based on Wolff’s Criteria
doi:10.7416/ai.2013.1915
di
D. Matranga, M.G.L. Marsala, M. Vadalà, M. Morici, V. Restivo, C. Ferrara, F. Vitale, A. Firenze
Objectives: To apply Wolff ’s Criteria to hospital discharge records (HDR) in order to detect adverse events
worthy of further study. Methods: Gynecology and Obstetrics Units of three Sicilian hospitals were considered and HDR regarding
ordinary and day hospital admissions in 2008 were collected. A matched case-control study was designed,
by random selection of 10 controls at maximum for each case. Matching was performed on the variables
age and speciality of admission (gynecology or obstetrics). Results: Out of a total of 7011 HDR examined, 114 cases were identified with Wolff ’s Criteria. Multivariate
analysis confirmed a statistically significant association with the origin of admission, diagnosis at the acceptance
and length of stay: there was a decreased risk of Wolff ’s event in patients having urgent admission
compared to elective (OR = 0.47, 95% CI = [0.28-0.78]), an increased risk in patients reporting tumor (OR
= 5:41, 95 % CI [1.89-15.47]) and other causes (OR = 2.16, 95% CI [1.10-4.24]) compared to delivery
diagnosis at acceptance and in patients whose length of stay was more than 6 days (OR = 23.17, 95% CI
= [12.56-42.7]) compared to less or equal than 3 days. Conclusion: Wolff ’s Criteria can be applied for the analysis of clinical risk in hospitals with different
structural characteristics, on condition that the HDR database is complete and good quality.
