Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries
<p><strong>Background:</strong> As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care.</p> <p><strong>Methods:</strong> We d...
| Κύριοι συγγραφείς: | , |
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| Μορφή: | Journal article |
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Oxford University Press
2016
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| _version_ | 1826284167482048512 |
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| author | International Surgical Outcomes Study group Gardiner, M |
| author_facet | International Surgical Outcomes Study group Gardiner, M |
| author_sort | International Surgical Outcomes Study group |
| collection | OXFORD |
| description | <p><strong>Background:</strong> As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care.</p> <p><strong>Methods:</strong> We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries.</p> <p><strong>Results:</strong> A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2–7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries.</p> <p><strong>Conclusions:</strong> Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care.</p> <p><strong>Study registration:</strong> ISRCTN51817007</p> |
| first_indexed | 2024-03-07T01:09:48Z |
| format | Journal article |
| id | oxford-uuid:8c9af80e-825d-45db-945f-56c9df4b7325 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T01:09:48Z |
| publishDate | 2016 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:8c9af80e-825d-45db-945f-56c9df4b73252022-03-26T22:45:38ZGlobal patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8c9af80e-825d-45db-945f-56c9df4b7325Symplectic Elements at OxfordOxford University Press2016International Surgical Outcomes Study groupGardiner, M<p><strong>Background:</strong> As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care.</p> <p><strong>Methods:</strong> We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries.</p> <p><strong>Results:</strong> A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2–7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries.</p> <p><strong>Conclusions:</strong> Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care.</p> <p><strong>Study registration:</strong> ISRCTN51817007</p> |
| spellingShingle | International Surgical Outcomes Study group Gardiner, M Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries |
| title | Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries |
| title_full | Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries |
| title_fullStr | Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries |
| title_full_unstemmed | Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries |
| title_short | Global patient outcomes after elective surgery: Prospective cohort study in 27 low-, middle- and high-income countries |
| title_sort | global patient outcomes after elective surgery prospective cohort study in 27 low middle and high income countries |
| work_keys_str_mv | AT internationalsurgicaloutcomesstudygroup globalpatientoutcomesafterelectivesurgeryprospectivecohortstudyin27lowmiddleandhighincomecountries AT gardinerm globalpatientoutcomesafterelectivesurgeryprospectivecohortstudyin27lowmiddleandhighincomecountries |