Publication details
Mortality after surgery in Europe: a 7 day cohort study
| Authors | |
|---|---|
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | The Lancet |
| MU Faculty or unit | |
| Citation | |
| Doi | http://dx.doi.org/10.1016/S0140-6736(12)61148-9 |
| Field | Surgery incl. transplantology |
| Keywords | SURGICAL QUALITY IMPROVEMENT; LONG-TERM SURVIVAL; NONCARDIAC SURGERY; CRITICAL-CARE; POSTOPERATIVE COMPLICATIONS; INPATIENT SURGERY; CANCER-SURGERY; MAJOR SURGERY; RISK; POPULATION |
| Description | Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe. We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used Chi-square and Fisher's exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at <0.05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries. We included 46539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1.2 days (IQR 0.9–3.6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1.2% [95% CI 0.0–3.0] for Iceland to 21.5% [16.9–26.2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0.44 [95% CI 0.19–1.05; p=0.06] for Finland to 6.92 [2.37–20.27; p=0.0004] for Poland). |