Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries
dc.contributor.author | Martin, Daniel | |
dc.date.accessioned | 2020-07-09T13:40:56Z | |
dc.date.available | 2020-07-09T13:40:56Z | |
dc.date.issued | 2016-11 | |
dc.identifier.issn | 0007-0912 | |
dc.identifier.issn | 1471-6771 | |
dc.identifier.uri | http://hdl.handle.net/10026.1/15943 | |
dc.description.abstract |
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. STUDY REGISTRATION: ISRCTN51817007 | |
dc.format.extent | 601-609 | |
dc.format.medium | ||
dc.language | en | |
dc.language.iso | en | |
dc.publisher | Elsevier BV | |
dc.subject | cohort studies | |
dc.subject | critical care/utilisation | |
dc.subject | operative/mortality | |
dc.subject | postoperative care/methods | |
dc.subject | postoperative care/statistics and numerical data | |
dc.subject | surgery | |
dc.subject | surgical procedures | |
dc.title | Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries | |
dc.type | journal-article | |
dc.type | Journal Article | |
dc.type | Multicenter Study | |
plymouth.author-url | https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000430670900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=11bb513d99f797142bcfeffcc58ea008 | |
plymouth.issue | 5 | |
plymouth.volume | 117 | |
plymouth.publication-status | Published | |
plymouth.journal | British Journal of Anaesthesia | |
dc.identifier.doi | 10.1093/bja/aew316 | |
plymouth.organisational-group | /Plymouth | |
plymouth.organisational-group | /Plymouth/Faculty of Health | |
plymouth.organisational-group | /Plymouth/Faculty of Health/Peninsula Medical School | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA | |
plymouth.organisational-group | /Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine | |
plymouth.organisational-group | /Plymouth/Users by role | |
plymouth.organisational-group | /Plymouth/Users by role/Academics | |
dc.publisher.place | England | |
dcterms.dateAccepted | 2016-08-08 | |
dc.identifier.eissn | 1471-6771 | |
dc.rights.embargoperiod | Not known | |
rioxxterms.versionofrecord | 10.1093/bja/aew316 | |
rioxxterms.licenseref.uri | http://www.rioxx.net/licenses/all-rights-reserved | |
rioxxterms.licenseref.startdate | 2016-11 | |
rioxxterms.type | Journal Article/Review |