Univerzitetni klinični center Maribor (SBMB)
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  • Mortality after surgery in Europe : a 7 day cohort study
    Pearse, Rupert M ...
    Background. 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. Methods. 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 X2 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 p<0.05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries. Findings. We included 46,539 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). Interpretation. The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.
    Vir: The Lancet. - ISSN 0140-6736 (Vol. 380, [no.] 9847, Sep. 2012, str. 1059-1065)
    Vrsta gradiva - članek, sestavni del ; neleposlovje za odrasle
    Leto - 2012
    Jezik - angleški
    COBISS.SI-ID - 4437567

    Povezava(-e):

    http://www.sciencedirect.com/science/article/pii/S0140673612611489
    DOI

vir: The Lancet. - ISSN 0140-6736 (Vol. 380, [no.] 9847, Sep. 2012, str. 1059-1065)

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