TY - JOUR
T1 - Mortality after surgery in Europe: a 7 day cohort study
AU - Pearse, Rupert M.
AU - Moreno, Rui P.
AU - Bauer, Peter
AU - Pelosi, Paolo
AU - Metnitz, Philipp
AU - Spies, Claudia
AU - Vallet, Benoit
AU - Vincent, Jean-Louis
AU - Hoeft, Andreas
AU - Rhodes, Andrew
AU - AUTHOR GROUP
AU - Moreno, Rui
AU - Pearse, Rupert
AU - Damster, Sandrine
AU - Golder, Kim
AU - Hewson, Russell
AU - Januszewska, Marta
AU - Leva, Brigitte
AU - Ramos, Vasco
AU - Hoste, Eric
AU - Huyghens, Luc
AU - Jacobs, Rita
AU - van Mossevelde, Veerle
AU - Opdenacker, Godelieve
AU - Poelaert, Jan
AU - Spapen, Herbert
AU - Leleu, Kris
AU - Rijckaert, Dirk
AU - de Decker, Koen
AU - Foubert, Luc
AU - de Neve, Nikolaas
AU - Biston, Patrick
AU - Piagnerelli, Michael
AU - Collin, Vincent
AU - Blauwen, Nadia den
AU - Clauwaert, Charlotte
AU - de Crop, Luc
AU - Verbeke, An
AU - Roeselare, Heilige Hartziekenhuis
AU - Derumeaux, Pieter
AU - Gardin, Christophe
AU - Kindt, Sebastiaan
AU - Louage, Sofie
AU - Verhamme, Bruno
AU - Druwé, Patrick
AU - Lahaye, Ingrid
AU - Rosseel, Francis
AU - Boerma, Christiaan
AU - Keijzer, Christaan
AU - Hollmann, Markus
AU - Preckel, Benedikt
PY - 2012
Y1 - 2012
N2 - 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 χ(2) 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. 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). 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. European Society of Intensive Care Medicine, European Society of Anaesthesiology
AB - 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 χ(2) 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. 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). 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. European Society of Intensive Care Medicine, European Society of Anaesthesiology
U2 - https://doi.org/10.1016/S0140-6736(12)61148-9
DO - https://doi.org/10.1016/S0140-6736(12)61148-9
M3 - Article
C2 - 22998715
SN - 0140-6736
VL - 380
SP - 1059
EP - 1065
JO - Lancet
JF - Lancet
IS - 9847
ER -