1. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group
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Ahmad, T, Bouwman, RA, Grigoras, I, Aldecoa, C, Hofer, C, Hoeft, A, Holt, P, Fleisher, LA, Buhre, W, Pearse, RM, Ferguson, Marissa, MacMahon, Michael, Shulman, Mark, Cherian, Ritchie, Currow, Helen, Kanathiban, Kathirgamanathan, Gillespie, David, Pathmanathan, Edward, Phillips, Katherine, Reynolds, Jenifer, Rowley, Joanne, Douglas, Jeanene, Kerridge, Ross, Garg, Sameer, Bennett, Michael, Jain, Megha, Alcock, David, Terblanche, Nico, Cotter, Rochelle, Leslie, Kate, Stewart, Marcelle, Zingerle, Nicolette, Clyde, Antony, Hambidge, Oliver, Rehak, Adam, Cotterell, Sharon, Huynh, Wilson Binh Quan, McCulloch, Timothy, Ben-Menachem, Erez, Egan, Thomas, Cope, Jennifer, Halliwell, Richard, Fellinger, Paul, Haisjackl, Markus, Haselberger, Simone, Holaubek, Caroline, Lichtenegger, Paul, Scherz, Florian, Schmid, Werner, Hoffer, Franz, Cakova, Veronika, Eichwalder, Andreas, Fischbach, Norbert, Klug, Reinhold, Schneider, Elisabeth, Vesely, Martin, Wickenhauser, Reinhart, Grubmueller, Karl Gernot, Leitgeb, Marion, Lang, Friedrich, Toro, Nancy, Bauer, Marlene, Laengle, Friedrich, Haberl, Claudia, Mayrhofer, Thomas, Trybus, Christoph, Buerkle, Christian, Forstner, Karin, Germann, Reinhard, Rinoesl, Harald, Schindler, Elke, Trampitsch, Ernst, Bogner, Gerhard, Dankl, Daniel, Duenser, Martin, Fritsch, Gerhard, Gradwohl-Matis, Ilse, Hartmann, Andreas, Hoelzenbein, Thomas, Jaeger, Tarkan, Landauer, Franz, Lindl, Gregor, Lux, Michael, Steindl, Johannes, Stundner, Ottokar, Szabo, Christian, Bidgoli, Jawad, Verdoodt, Hans, Forget, Patrice, Kahn, David, Lois, Fernande, Momeni, Mona, Pregardien, Caroline, Pospiech, Audrey, Steyaert, Arnaud, Veevaete, Laurent, De Kegel, Dirk, De Jongh, Karen, Foubert, Luc, Smitz, Carine, Vercauteren, Marcel, Poelaert, Jan, Van Mossevelde, Veerle, Abeloos, Jacques, Bouchez, Stefaan, Coppens, Marc, De Baerdemaeker, Luc, Deblaere, Isabel, De Bruyne, Ann, De Hert, Stefan, Fonck, Kristine, Heyse, Bjorn, Jacobs, Tom, Lapage, Koen, Moerman, Anneliese, Neckebroek, Martine, Parashchanka, Aliaksandra, Roels, Nathalie, Van Den Eynde, Nancy, Vandenheuvel, Michaël, van Limmen, Jurgen, Vanluchene, Ann, Vanpeteghem, Caroline, Wouters, Patrick, WYFFELS, PIET, Huygens, Christel, Vandenbempt, Punitha, Van de Velde, Marc, Dylst, Dimitri, Janssen, Bruno, Schreurs, Evelien, Aleixo, Fabia Berganton, Candido, Keulle, Batista, Hugo Dias, Guimaraes, Mario, Guizeline, Jaqueline, Hoffmann, Joao, Lobo, Suzana, Marques Lobo, Francisco Ricardo, Nascimento, Vinicius, Nishiyama, Katia, Pazetto, Lucas, Souza, Daniela, Rodrigues, Rodrigo Souza, Vilela dos Santos, Ana Maria, Jardim, Jaquelline, Sa Malbouisson, Luiz Marcelo, Silva, Joao, do Nascimento Junior, Paulo, Baio, Thalissa Herminia, Pereira de Castro, Gabriel Isaac, Watanabe Oliveira, Henri Roger, Amendola, Cristina Prata, Cardoso, Gutemberg, Ortega, Daniela, Brotto, Ana Flavia, De Oliveira, Mirella Cristine, Rea-Neto, Alvaro, Dias, Fernando, Travi, Maria Eduarda, Zerman, Luiza, Azambuja, Pedro, Knibel, Marcos Freitas, Martins, Antonio, Almeida, William, Neder Neto, Calim, Tardelli, Maria Angela, Caser, Eliana, Machado, Marcio, Aguzzoli, Crisitiano, Baldisserotto, Sergio, Tabajara, Fernanda Beck, Bettega, Fernanda, Rodrigues Junior, La Hore Correa, de Gasperi, Julia, Faina, Lais, Nolasco, Marcos Farias, da Costa Fischer, Bruna Ferreira, de Campos Ferreira, Mariana Fosch, Hartmann, Cristina, Kliemann, Marta, Ribeiro, Gustavo Luis Hubert, Fraga, Julia Merladete, Netto, Thiago Motta, Pozza, Laura Valduga, Wendling, Paulo Rafael, Azevedo, Caroline, Garcia, Juliana, Lopes, Marcel, Maia, Bernardo, Maselli, Paula, Melo, Ralph, Mendes, Weslley, Neves, Matheus, Ney, Jacqueline, Piras, Claudio, Applewhaite, Christopher, Carr, Adrienne, Chow, Lorraine, Duttchen, Kaylene, Foglia, Julena, Greene, Michael, Hinther, Ashley, Houston, Kendra, McCormick, Thomas Jared, Mikhayel, Jennifer, Montasser, Sam, Ragan, Alex, Suen, Andrew, Woolsey, Adrianna, Yu, Hai Chuan, Funk, Duane, Kowalski, Stephen, Legaspi, Regina, McDonald, Heather, Siddiqui, Faisal, Pridham, Jeremy, Rowe, Bernadette, Sampson, Sonia, Thiessen, Barton, Zbitnew, Geoff, Bernard, Andre, George, Ronald, Jones, Philip, Moor, Rita, Siddiqui, Naveed, Wolfer, Alexandra, Tran, Diem, Winch, Denyse, Dobson, Gary, McCormick, Thomas, Montasser, Osama, Hall, Richard, Baghirzada, Leyla, Curley, Gerard, Dai, Si Yuan, Hare, Gregory, Lee, Esther, Shastri, Uma, Tsui, Albert, Yagnik, Anmol, Alvares, Danielle, Choi, Stephen, Dwyer, Heather, Flores, Kathrina, McCartney, Colin, Somascanthan, Priya, Beattie, Scott, Carroll, Jo, Pazmino-Canizares, Janneth, Wijeysundera, Duminda, Ami, Noam, Chan, Vincent, Perlas, Anahi, Argue, Ruth, Huang, Yang, Lavis, Katie, Mayson, Kelly, Cao, Ying, Gao, Hong, Hu, Tingju, Lv, Jie, Yang, Jian, Yang, Yang, Zhong, Yi, Zhou, Jing, Zou, Xiaohua, He, Miao, Li, Xiaoying, Luo, Dihuan, Wang, Haiying, Yu, Tian, Chen, Liyong, Wang, Lijun, Cai, Yunfei, Cao, Zhongming, Li, Yanling, Lian, Jiaxin, Sun, Haiyun, Wang, Sheng, Wang, Zhipeng, Wang, Kenru, Zhu, Yi, Du, Xindan, Fan, Hao, Fu, Yunbin, Huang, Lixia, Huang, Yanming, Hwan, Haifang, Luo, Hong, Qu, Pi-Sheng, Tao, Fan, Wang, Zhen, Wang, Guoxiang, Wang, Shun, Zhang, Yan, Zhang, Xiaolin, Chen, Chao, Wang, Weixing, Liu, Zhengyuan, Fan, Lihua, Tang, Jing, Chen, Yijun, Chen, Yongjie, Han, Yangyang, Huang, Changshun, Liang, Guojin, Shen, Jing, Wang, Jun, Yang, Qiuhong, Zhen, Jungang, Zhou, Haidong, Chen, Junping, Chen, Zhang, Li, Xiaoyu, Meng, Bo, Ye, Haiwang, Zhang, Xiaoyan, Bi, Yanbing, Cao, Jianqiao, Guo, Fengying, Lin, Hong, Liu, Yang, Lv, Meng, Shi, Pengcai, Song, Xiumei, Sun, Chuanyu, Sun, Yongtao, Wang, Yuelan, Wang, Shenhui, Zhang, Min, Chen, Rong, Hou, Jiabao, Leng, Yan, Meng, Qing-tao, Qian, Li, Shen, Zi-ying, Xia, Zhong-yuan, Xue, Rui, Zhang, Yuan, Zhao, Bo, Zhou, Xian-jin, Chen, Qiang, Guo, Huinan, Guo, Yongqing, Qi, Yuehong, Wang, Zhi, Wei, Jianfeng, Zhang, Weiwei, Zheng, Lina, Bao, Qi, Chen, Yaqiu, Chen, Yijiao, Fei, Yue, Hu, Nianqiang, Hu, Xuming, Lei, Min, Li, Xiaoqin, Lv, Xiaocui, Miao, Fangfang, Ouyang, Lingling, Qian, Lu, Shen, Conyu, Sun, Yu, Wang, Yuting, Wang, Dong, Wu, Chao, Xu, Liyuan, Yuan, Jiaqi, Zhang, Lina, Zhang, Huan, Zhang, Yapping, Zhao, Jinning, Zhao, Chong, Zhao, Lei, Zheng, Tianzhao, Zhou, Dachun, Zhou, Haiyan, Zhou, Ce, Lu, Kaizhi, Zhao, Ting, He, Changlin, Chen, Hong, Chen, Shasha, Cheng, Baoli, He, Jie, Jin, Lin, Li, Caixia, Li, Hui, Pan, Yuanming, Shi, Yugang, Wen, Xiao Hong, Wu, Shuijing, Xie, Guohao, Zhang, Kai, Zhao, Bing, Lu, Xianfu, Chen, Feifei, Liang, Qisheng, Lin, Xuewu, Ling, Yunzhi, Liu, Gang, Tao, Jing, Yang, Lu, Zhou, Jialong, Chen, Fumei, Cheng, Zhonggui, Dai, Hanying, Feng, Yunlin, Hou, Benchao, Gong, Haixia, Hu, Chun Hua, Huang, Haijin, Huang, Jian, Jiang, Zhangjie, Li, Mengyuan, Lin, Jiamei, Liu, Mei, Liu, Weicheng, Liu, Zhen, Liu, Zhiyi, Luo, Foquan, Ma, Longxian, Min, Jia, Shi, Xiaoyun, Song, Zhiping, Wan, Xianwen, Xiong, Yingfen, Xu, Lin, Yang, Shuangjia, Zhang, Qin, Zhang, Hongyan, Zhang, Huaigen, Zhang, Xuekang, Zhao, Lili, Zhao, Weihong, Zhao, Weilu, Zhu, Xiaoping, Bai, Yun, Chen, Linbi, Chen, Sijia, Dai, Qinxue, Geng, Wujun, Han, Kunyuan, He, Xin, Huang, Luping, Ji, Binbin, Jia, Danyun, Jin, Shenhui, Li, Qianjun, Liang, Dongdong, Luo, Shan, Lwang, Lulu, Mo, Yunchang, Pan, Yuanyuan, Qi, Xinyu, Qian, Meizi, Qin, Jinling, Ren, Yelong, Shi, Yiyi, Wang, Junlu, Wang, Junkai, Wang, Leilei, Xie, Junjie, Yan, Yixiu, Yao, Yurui, Zhang, Mingxiao, Zhao, Jiashi, Zhuang, Xiuxiu, Ai, Yanqiu, Du, Fang, He, Long, Huang, Ledan, Li, Zhisong, Li, Huijuan, Li, Yetong, Li, Liwei, Meng, Su, Yuan, Yazhuo, Zhang, Enman, Zhang, Jie, Zhao, Shuna, Ji, Zhenrong, Pei, Ling, Wang, Li, Chen, Chen, Dong, Beibei, Li, Jing, Miao, Ziqiang, Mu, Hongying, Qin, Chao, Su, Lin, Wen, Zhiting, Xie, Keliang, Yu, Yonghao, Yuan, Fang, Hu, Xianwen, Zhang, Ye, Xiao, Wangpin, Zhu, Zhipeng, Dai, Qingqing, Fu, Kaiwen, Hu, Rong, Hu, Xiaolan, Huang, Song, Li, Yaqi, Liang, Yingping, Yu, Shuchun, Guo, Zheng, Jing, Yan, Tang, Na, Wu, Jie, Yuan, Dajiang, Zhang, Ruilin, Zhao, Xiaoying, Li, Yuhong, Bai, Hui-Ping, Liu, Chun-Xiao, Liu, Fei-Fei, Ren, Wei, Wang, Xiu-Li, Xu, Guan-Jie, Hu, Na, Li, Bo, Ou, Yangwen, Tang, Yongzhong, Yao, Shanglong, Zhang, Shihai, Kong, Cui-Cui, Liu, Bei, Wang, Tianlong, Xiao, Wei, Lu, Bo, Xia, Yanfei, Zhou, Jiali, Cai, Fang, Chen, Pushan, Hu, Shuangfei, Wang, Hongfa, Xu, Qiong, Hu, Liu, Jing, Liang, Li, Bin, Liu, Qiang, Liu, Yuejiang, Lu, Xinjian, Peng, Zhen Dan, Qiu, Xiaodong, Ren, Quan, Tong, Youliang, Wang, Jin, Wen, Yazhou, Wu, Qiong, Xia, Jiangyan, Xie, Jue, Xiong, Xiapei, Xu, Shixia, Yang, Tianqin, Ye, Hui, Yin, Ning, Yuan, Jing, Zeng, Qiuting, Zhang, Baoling, Zheng, Kang, Cang, Jing, Chen, Shiyu, Fan, Yu, Fu, Shuying, Ge, Xiaodong, Guo, Baolei, Huang, Wenhui, Jiang, Linghui, Jiang, Xinmei, Liu, Yi, Pan, Yan, Ren, Yun, Shan, Qi, Wang, Jiaxing, Wang, Fei, Wu, Chi, Zhang, Xiaoguang, Christiansen, Ida Cecilie, Granum, Simon Norgaard, Rasmussen, Bodil Steen, Daugaard, Morten, Gambhir, Rajiv, Brandsborg, Birgitte, Steingrimsdottir, Guony Erla, Jensen-Gadegaard, Peter, Olsen, Karsten Skovgaard, Siegel, Hanna, Eskildsen, Katrine Zwicky, Gatke, Mona Ring, Wibrandt, Ida, Heintzelmann, Simon Bisgaard, Lange, Kai Henrik Wiborg, Lundsgaard, Rune Sarauw, Amstrup-Hansen, Louise, Hovendal, Claus, Larsen, Michael, Lenstrup, Mette, Kobborg, Tina, Larsen, Jens Rolighed, Pedersen, Anette Barbre, Smith, Soren Hubertz, Oestervig, Rebecca Monett, Rasmussen, Lars, Afshari, Arash, Andersen, Cheme, Ekelund, Kim, Secher, Erik Lilja, Beloeil, Helene, Lasocki, Sigismond, Venara, Aurelien, Biais, Matthieu, Ouattara, Alexandre, Sineus, Marlene, Molliex, Serge, Legouge, Marie Lim, Wallet, Florent, Tesniere, Antoine, Gaudin, Christophe, Lehur, Paul, Forsans, Emma, de Rudnicki, Stephane, Maudet, Valerie Serra, Mutter, Didier, Sojod, Ghassan, Ouaissi, Mehdi, Regimbeau, Jean-Marc, Futier, Emmanuel, Desbordes, Jacques, Comptaer, Nicolas, el Manser, Diae, Ethgen, Sabine, Lebuffe, Gilles, Auer, Patrick, Haertl, Christine, Deja, Maria, Legashov, Kirill, Sonnemann, Susanne, Wiegand-Loehnert, Carola, Falk, Elke, Habicher, Marit, Angermair, Stefan, Laetsch, Beatrix, Schmidt, Katrin, Von Heymann, Christian, Ramminger, Axel, Jelschen, Florian, Pabel, Svenja, Weyland, Andreas, Czeslick, Elke, Gille, Jochen, Malcharek, Michael, Sablotzki, Armin, Lueke, Katharina, Wetzel, Peter, Weimann, Joerg, Lenhart, Franz-Peter, Reichle, Florian, Schirmer, Frederike, Hueppe, Michael, Klotz, Karl, Nau, Carla, Schoen, Julika, Mencke, Thomas, Wasmund, Christina, Bankewitz, Carla, Baumgarten, Georg, Fleischer, Andreas, Guttenthaler, Vera, Hack, Yvonne, Hoeft, Andreas, Kirchgaessner, Katharina, Maenner, Olja, Schurig-Urbaniak, Marlen, Struck, Rafael, van Zyl, Rebekka, Wittmann, Maria, Goebel, Ulrich, Harris, Sarah, Veit, Siegfried, Andreadaki, Evangelia, Souri, Flora, Katsiadramis, Ioannis, Skoufi, Anthi, Vasileiou, Maria, Aimoniotou-Georgiou, Eleni, Katsourakis, Anastasios, Veroniki, Fotini, Vlachogianni, Glyceria, Petra, Konstantina, Chlorou, Dimitra, Oloktsidou, Eirini, Ourailoglou, Vasileios, Papapostolou, Konstantinos, Tsaousi, Georgia, Daikou, Panagoula, Dedemadi, Georgia, Kalaitzopoulos, Ioannis, Loumpias, Christos, Bristogiannis, Sotirios, Dafnios, Nikolaos, Gkiokas, Georgios, Kontis, Elissaios, Kozompoli, Dimitra, Papailia, Aspasia, Theodosopoulos, Theodosios, Bizios, Christol, Koutsikou, Anastasia, Moustaka, Aleaxandra, Plaitakis, Ioannis, Armaganidis, Apostolos, Christodoulopoulou, Theodora, Lignos, Mihail, Theodorakopoulou, Maria, Asimakos, Andreas, Ischaki, Eleni, Tsagkaraki, Angeliki, Zakynthinos, Spyros, Antoniadou, Eleni, Koutelidakis, Ioannis, Lathyris, Dimitrios, Pozidou, Irene, Voloudakis, Nikolaos, Dalamagka, Maria, Elena, Gkonezou, Chronis, Christos, Manolakaki, Dimitra, Mosxogiannidis, Dimitris, Slepova, Tatiana, Tsakiridou, Isaia-sissy, Lampiri, Claire, Vachlioti, Anastasia, Panagiotakis, Christos, Sfyras, Dimitrios, Tsimpoukas, Fotios, Tsirogianni, Athanasia, Axioti, Elena, Filippopoulos, Andreas, Kalliafa, Elli, Kassavetis, George, Katralis, Petros, Komnos, Ioannis, Pilichos, Georgios, Ravani, Ifigenia, Totis, Antonis, Apagaki, Eymorfia, Efthymiadi, Andromachi, Kampagiannis, Nikolaos, Paraforou, Theoniki, Tsioka, Agoritsa, Georgiou, Georgios, Vakalos, Aristeidis, Bairaktari, Aggeliki, Charitos, Efthimios, Markou, George, Niforopoulou, Panagiota, Papakonstantinou, Nikolaos, Tsigou, Evdoxia, Xifara, Archontoula, Zoulamoglou, Menelaos, Gkioni, Panagiota, Karatzas, Stylianos, Kyparissi, Aikaterini, Mainas, Efstratios, Papapanagiotou, Ioannis, Papavasilopoulou, Theonymfi, Fragandreas, George, Georgopoulou, Eleni, Katsika, Eleni, Psarras, Kyriakos, Synekidou, Eirini, Verroiotou, Maria, Vetsiou, Evangelia, Zaimi, Donika, Anagnou, Athina, Apostolou, Konstantinos, Melissopoulou, Theodora, Rozenberg, Theophilos, Tsigris, Christos, Boutsikos, Georgios, Kalles, Vasileios, Kotsalas, Nikolaos, Lavdaiou, Christina, Paikou, Fotini, Panagou, Georgia-Laura, Spring, Anna, Arvaniti, Kostoula, Botis, Ioannis, Drimala, Maria, Georgakakis, Georgios, Kiourtzieva, Ellada, Ntouma, Panagiota, Prionas, Apostolos, Xouplidis, Kyriakos, Dalampini, Eleftheria, Giannaki, Chrysavgi, Iasonidou, Christina, Ioannidis, Orestis, Lavrentieva, Athina, Lavrentieva, Athena, Papageorgiou, George, Kokkinoy, Maria, Stafylaraki, Maria, Gaitanakis, Stylianos, Karydakis, Periclis, Paltoglou, Josef, Ponireas, Panagiotis, Chaloulis, Panagiotis, Provatidis, Athanasios, Sousana, Anisoglou, Gardikou, Varvara Vanessa, Konstantivelli, Maria, Lataniotou, Olga, Lisari, Elisavet, Margaroni, Maria, Stamatiou, Konstantinos, Nikolaidis, Edouardos, Pnevmatikos, Ioannis, Sertaridou, Eleni, Andreou, Alexandros, Arkalaki, Eleni, Athanasakis, Elias, Chaniotaki, Fotini, Chatzimichali, Chatzimichali Aikaterini, Christofaki, Maria, Dermitzaki, Despina, Fiorentza, Klara, Frantzeskos, Georgios, Geromarkaki, Elisavet, Kafkalaki, Kalliopi, Kalogridaki, Marina, Karydi, Konstyllia, Kokkini, Sofia, Kougentakis, Georgios, Lefaki, Tatiana, Lilitsis, Emmanouhl, Makatounaki, Aikaterini, Malliotakis, Polychronis, Michelakis, Dimosthenis, Neonaki, Maria, Nyktari, Vasileia, Palikyra, Iliana, Papadakis, Eleftherios, Papaioannou, Alexandra, Sfakianakis, Konstantinos, Sgouraki, Maria, Souvatzis, Xenia, Spartinou, Anastasia, Stefanidou, Nefeli, Syrogianni, Paulina, Tsagkaraki, Georgia, Arnaoutoglou, Elena, Arnaoutoglou, Christina, Bali, Christina, Bouris, Vasilios, Doumos, Rodamanthos, Gkini, Konstantia-Paraskevi, Kapaktsi, Clio, Koulouras, Vasilios, Lena, Arian, Lepida, Dimitra, Michos, Evangelos, Papadopoulos, Dimitrios, Paschopoulos, Minas, Rompou, Vaia Aliki, Siouti, Ioanna, Tsampalas, Stavros, Ververidou, Ourania, Zilis, Georgios, Charlalampidoy, Alexandra, Christodoulidis, Gregory, Flossos, Andreas, Stamoulis, Konstantinos, Chan, Matthew, Tsang, Man Shing Caleb, Tsang, Man Shing, Lai, Man Ling, Yip, Chi Pang, Chan, Hey Man Heymans, Law, Bassanio, Li, Wing Sze, Chu, Hiu Man, Koo, Emily Gar Yee, Lam, Chi Cheong Joe, Cheng, Ka Ho, Lam, Tracy, Chu, Susanna, Lam, Wing yan, Wong, Kin Wai Kevin, Kwok, Dilys, Hung, Ching Yue Janice, Chan, Wai Kit Jacky, Wong, Wing Lam, Chung, Chun Kwong Eric, Ma, Shu Kai, Kaushik, Shuchi, Shah, Bhagyesh, Shah, Dhiren, Shah, Sanjay, Ar, Praburaj, Muthuchellappan, Radhakrishnan, Agarwal, Vandana, Divatia, Jigeeshu, Kulkarni, Atul, Mishra, Sanghamitra, Nimje, Ganesh, Pande, Swati, Savarkar, Sukhada, Shrivastava, Aditi, Thomas, Martin, Yegnaram, Shashikant, Hidayatullah, Rahmat, Chandra, Susilo, Tantri, Aida, Puar, Nasman, Niman, Sumara, Indra, Imai, Hamzah, Zulkarnain, Yuliana, Annika, Abidin, Ucu Nurhadiat, Dursin, Ade Nurkacan, Kurnia, Andri, Susanti, Ade, Handayani, Dini, Alit, Mahaalit Aribawa, Arya, Aryabiantara, Senapathi, Tjokorda Gde Agung, Utara, Utara Hartawan, Wid, Widnyana Made, Wima, Semarawima, Wir, Wiryana Made, Jehosua, Brillyan, Kaunang, Jonathan, Lantang, Eka Yudha, Najoan, Rini, 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- Subjects
surgery ,postoperative care/methods ,cohort studies ,operative/mortality ,data ,postoperative care/statistics and numerical ,Medicine and Health Sciences ,critical care/utilisation ,surgical procedures - 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 amedian 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.
- Published
- 2016