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Br J Surg. 2019 Jan;106(2):e103-e112. doi: 10.1002/bjs.11051.

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy.

Collaborators (3445)

Thomas HS, Weiser TG, Drake TM, Knight SR, Fairfield C, Ademuyiwa AO, Aguilera ML, Alexander P, Al-Saqqa SW, Borda-Luque G, Costas-Chavarri A, Ntirenganya F, Fitzgerald JE, Fergusson SJ, Glasbey J, Ingabire JCA, Ismaïl L, Salem HK, Kojo ATT, Lapitan MC, Lilford R, Mihaljevic AL, Morton D, Mutabazi AZ, Nepogodiev D, Adisa AO, Ots R, Pata F, Pinkney T, Poškus T, Qureshi AU, la Medina AR, Rayne S, Shaw CA, Shu S, Spence R, Smart N, Tabiri S, Bhangu A, Harrison EM, Harrison EM, Verjee A, Runigamugabo E, Ademuyiwa AO, Adisa AO, Aguilera ML, Altamini A, Alexander P, Al-Saqqa SW, Borda-Luque G, Cornick J, Costas-Chavarri A, Drake TM, Fergusson SJ, Fitzgerald JE, Glasbey J, Ingabire JCA, Ismaïl L, Jaffry Z, Salem HK, Khatri C, Kirby A, Kojo ATT, Lapitan MC, Lilford R, Mihaljevic AL, Mohan M, Morton D, Mutabazi AZ, Nepogodiev D, Ntirenganya F, Ots R, Pata F, Pinkney T, Poškus T, Qureshi AU, la Medina AR, Rayne S, Recinos G, Søreide K, Shaw CA, Shu S, Spence R, Smart N, Tabiri S, Harrison EM, Bhangu A, Khatri C, Gobin N, Freitas AV, Hall N, Kim SH, Negida A, Khairy H, Jaffry Z, Chapman SJ, Arnaud AP, Tabiri S, Recinos G, Manipal CE, Mohan M, Amandito R, Shawki M, Hanrahan M, Pata F, Zilinskas J, Roslani AC, Goh CC, Ademuyiwa AO, Irwin G, Shu S, Luque L, Shiwani H, Altamimi A, Alsaggaf MU, Fergusson SJ, Spence R, Rayne S, Jeyakumar J, Cengiz Y, Raptis DA, Glasbey JC, Modolo MM, Iyer D, King S, Arthur T, Nahar SN, Waterman A, Walsh LI, Agarwal A, Zani A, Firdouse M, Rouse T, Liu Q, Correa JC, Salem HK, Talving P, Worku M, Arnaud A, Tabiri S, Kalles V, Aguilera ML, Recinos G, Kumar B, Kumar S, Amandito R, Quek R, Pata F, Ansaloni L, Altibi A, Venskutonis D, Zilinskas J, Poskus T, Whitaker J, Msosa V, Tew YY, Farrugia A, Borg E, la Medina AR, Bentounsi Z, Ademuyiwa AO, Søreide K, Gala T, Al-Slaibi I, Tahboub H, Alser OH, Romani D, Shu S, Major P, Mironescu A, Bratu M, Kourdouli A, Ndajiwo A, Altwijri A, Alsaggaf MU, Gudal A, Jubran AF, Seisay S, Lieske B, Rayne S, Spence R, Ortega I, Jeyakumar J, Senanayake KJ, Abdulbagi O, Cengiz Y, Raptis D, Altinel Y, Kong C, Teasdale E, Irwin G, Stoddart M, Kabariti R, Suresh S, Gash K, Narayanan R, Maimbo M, Fermani C, Balmaceda R, Modolo MM, Macdermid E, Gobin N, Chenn R, Yong CO, Edye M, Jarmin M, D'amours SK, Iyer D, Youssef D, Phillips N, Brown J, George R, Koh C, Warren O, Hanley I, Dickfos M, Nawara C, Öfner D, Primavesi F, Mitul AR, Mahmud K, Hussain M, Hakim H, Kumar T, Oosterkamp A, Assouto PA, Lawani I, Souaibou YI, Tun AK, Chong CL, Devadasar GH, Chong CL, Qadir MRM, Aung KP, Yeo LS, Chong CL, Castillo VDP, Munhoz MM, Moreira G, Segundo LCBC, Ferreira SAK, Careta MC, Kim SB, De Sousa AV, Cury ADL, Miguel GPS, De Freitas AVC, Silvestre BP, Vianna JGP, Felipe CO, Laufer LAV, Altoe F, Da Silva LA, Pimenta ML, Giuriato TF, Morais PAB, Luiz JS, Araujo R, Menegussi J, Leal M, de Lima CVB, Tatagiba LS, Leal A, Dos Santos DV, Fraga GP, Simoes RL, Stock S, Nigo S, Kabba J, Ngwa TE, Brown J, King S, Zani A, Azzie G, Firdouse M, Kushwaha S, Agarwal A, Bailey K, Cameron B, Livingston M, Horobjowsky A, Deckelbaum DL, Razek T, Marinkovic B, Grasset E, D'aguzan N, Grasset E, Jimenez J, Macchiavello R, Zhang Z, Guo W, Oh J, Zheng F, Montes I, Sierra S, Mendez M, Villegas MI, Arango MCM, Mendoza I, Aristizã Bal FAN, Botero JAM, Riaza VMQ, Restrepo J, Morales C, Arango MCM, Cruz H, Munera A, Arango MCM, Karlo R, Domini E, Mihanovic J, Radic M, Zamarin K, Pezelj N, Hache-Marliere M, Lemaire SB, Rivas R, Khyrallh A, Hassan A, Shimy G, Baky Fahmy MA, Nabawi A, Elfil M, Ghoneem M, Gohar MEAM, Asal M, Abdelkader M, Gomah M, Rashwan H, Karkeet M, Gomaa A, Hasan A, Elgebaly A, Saleh O, Fattah AA, Gouda A, Elshafay AE, Gharib A, Menshawy A, Hanafy M, Al-Mallah A, Abdulgawad M, Baheeg M, Alhendy M, AbdelFattah I, Kenibar A, Osman O, Gemeah M, Mohammed A, Adel A, Gharib A, Mohammed A, Sayed A, Abozaid M, Kotb AHE, Ata AAA, Nasr M, Alkammash A, Saeed M, El Hamid NA, Attia AM, El Galeel AA, Elbanby E, El-Dien KS, Hantour U, Alahmady O, Mansour B, Elkorashy AM, Taha EMS, Lasheen KT, Elkolaly SS, Abdel-Wahab NYE, Abozyed MAF, Adel A, Saeed AM, El Sayed GS, Youssif JH, Ahmed SM, El-Shahat NS, Khedr AEH, Elsebaaye AO, Elzayat M, Abdelraheim M, Elzayat I, Warda M, El Deen KN, Elnemr AE, Salah O, Abbas M, Rashad M, Elzayyat I, Hemeda D, Tawfik G, Salama M, Khaled H, Seisa M, Elshaer K, Hussein A, Elkhadrawi M, Afifi AM, Ebrahim OS, Metwally MM, Elmelegy R, Elsawahly DME, Safa H, Nofal E, Elbermawy M, Ghazy AA, Samih H, Abdelgelil A, Abdelghany S, El Kholy A, Aboraya M, Elkady F, Salma M, Samy S, Fakher R, Aboarab A, Samir A, Sakr A, Haroun A, Al-Aarag AA, Elkholy A, Elshanwany S, Ghanem E, Tammam A, Hammad AM, El Shoura Y, El Ashal G, Khairy H, Antar S, Mehrez S, Abdelshafy M, Hamad MGM, Hosh M, Abdallah E, Magdy B, Alzayat T, Gamaly E, Elfeki H, Abouzahra A, Elsheikh S, Elgendy FI, El-Salam FA, Seifelnasr O, Ammar M, Eysa A, Sadek A, Toeema AG, Nasr A, Abuseif M, Zidan H, Barakat SAE, Elsayed N, Elrasoul YA, Elkelany A, Ammar MS, Mustafa MA, Hegazy Y, Etman M, Saad S, Alrahawy M, Raslan A, Morsi M, Rslan A, Sabry A, Elwakil H, Shaker H, Zidan H, Abd-Elrasoul Y, Elkelany A, El-Kashef H, Shaalan M, Tarek A, Elwan A, Nayel AR, Seif M, Elwan A, Emadeldin D, Ghonaim MA, Almallah A, Fouad A, Sayma EA, Elbatahgy A, El-Ma'doul AS, Mosad A, Tolba H, Elsorogy DEAA, Mostafa HA, Omar AA, El Hameed OSA, Lasheen A, El Salam YA, Morsi A, Ismail M, El-Badawy HA, Amer MA, Elkelany A, Elkelany A, El-Hamouly AS, Attallah NA, Mosalum O, Afandy A, Mokhtar A, Abouelnasr A, Ayad S, Shaker R, Sakr R, Shaker R, Amreia M, Elsobky S, Mustafa M, El Magd AA, Marey A, Hafez AT, Zalabia MF, Mohamed MM, Fadel A, Ahmed EA, Ali A, Alwafai MG, Dwydar A, Kharsa S, Mamdouh E, El-Sheemy H, AlYoussef I, Aly AK, Aldalaq A, Alnawam E, Alkhabbaz D, Saad M, Hussein S, Elazayem AA, Meshref A, Elashmawy M, Mousa M, Nashaat A, Ghanem S, Elsayed ZM, Elwaey A, Elkadsh I, Darweesh M, Mohameden A, Hafez M, Badr A, Badwy A, El Slam MA, Elazoul M, Al-Nahrawi S, Eldamaty L, Nada F, Ameen M, Hagar A, Elsehimy M, Aboraya M, Dawoud H, El Mesery S, El Gendy A, Abdelkareem A, Marey AS, Allam M, Shehata S, Abozeid K, Elshobary M, Fahiem A, Sarsik S, Hashish A, Zidan M, Hashish M, Aql S, Elhendawy AOA, Husseini M, Kasem E, Gheith A, Elfouly Y, Soliman AR, Ibrahim Y, Elfouly N, Fawzy A, Hassan A, Rashid M, Elsherbiny AS, Sieda B, Badwi NM, Mohammed MMH, Mohamed O, Habeeb MA, Worku M, Starr N, Desta S, Wondimu S, Abebe NS, Thomas E, Asele FA, Dabessa D, Abebe NS, Zerihun AB, Mentula P, Leppäniemi A, Sallinen V, Scalabre A, Frade F, Irtan S, Graffeille V, Gaignard E, Alimi Q, Alimi Q, Graffieille V, Gaignard E, Abbo O, Mouttalib S, Bouali O, Hervieux E, Aigrain Y, Botto N, Faure A, Fievet L, Panait N, Eyssartier E, Schmitt F, Podevin G, Parent V, Martin A, Arnaud AP, Muller C, Bonnard A, Peycelon M, Abantanga F, Boakye-Yiadom K, Bukari M, Owusu F, Awuku-Asabre J, Tabiri S, Bray LD, Lytras D, Psarianos K, Bamicha A, Kefalidi E, Gemenetzis G, Dervenis C, Gouvas N, Agalianos C, Kontos M, Kouraklis G, Karousos D, Germanos S, Marinos C, Anthoulakis C, Nikoloudis N, Mitroudis N, Recinos G, Estupinian S, Forno W, Azmitia JRA, Cabrera CCR, Guevara R, Aguilera M, Mendez N, Mendizabal CAA, Ramazzini P, Urquizu MC, Tale F, Soley R, Barrios E, Barrios E, Rodríguez DEM, Velásquez CIP, Mérida SMC, Regalado F, Lopez M, Siguantay M, Lam FY, Szeto KJ, Szeto CCL, Li WS, Li KKK, Leung MF, Mak T, Ng S, Prasad SS, Kirishnan A, Gyanchandani N, Kumar BS, Rangarajan M, Bhat S, Sreedharan A, Kinnera SV, Reddy Y, Venugopal C, Kumar S, Mittal A, Nadkarni S, Lakshmi HN, Malik P, Limaye N, Pai S, Jain P, Khajanchi M, Satoskar S, Satoskar R, Mahamood AB, Sutanto EPR, Soeselo DA, Tedjaatmadja C, Rahmawati FN, Amandito R, Mayasari M, Al-Hasani RKMJ, Al-Hameedi HII, Ibraheem HI, Al-Azraqi IAA, Sabeeh L, Kamil R, Shawki M, Telfah MM, Rasendran A, Sheehan J, Kerley R, Normile C, Gilbert RW, Song J, Dablouk M, Mauro L, Dablouk MO, Hanrahan M, Kielty P, Marks E, Gosling S, Mccarthy M, Rasendran A, Mirghani D, Naqvi SA, Wong CS, Chung S, D'cruz R, Cahill R, Gosling SG, Mccarthy M, Rasendran A, Fahy C, Song J, Hanrahan M, Cadogan DD, Powell A, Gilbert R, Clifford C, Normile C, Driscoll A, Paul S, Lee C, Bowe R, Hutch W, Hanrahan M, Mohan H, O'neill M, Mealy K, Danelli P, Bondurri A, Maffioli A, Pasini M, Pata G, Roncali S, Silvani P, Carlucci M, Faccincani R, Bonavina L, Macchitella Y, Ceriani C, Tugnoli G, Di Saverio S, Khattab K, Paludi MA, Pata D, Cloro LM, Allegri A, Ansaloni L, Coccolini F, Veronese E, Bortolasi L, Hasheminia A, Nastri G, Canto MD, Cucumazzo S, Pata F, Benevento A, Tessera G, Grandinetti PP, Maniscalco A, Lamanna GL, Turati L, Sgroi G, Rausa E, Villa R, Monteleone M, Merlini D, Coccolini F, Ansaloni L, Allegri A, Grassi V, Cirocchi R, Cacurri A, Waleed H, Diab A, Elzowawi F, Jokubauskas M, Varkalys K, Venskutonis D, Pranevicius R, Ambrozeviciute V, Juciute S, Skardžiukaitė A, Venskutonis D, Bradulskis S, Urbanavicius L, Austraite A, Riauka R, Zilinskas J, Dambrauskas Z, Karumnas P, Urniezius Z, Zilinskiene R, Rudzenskaite A, Usaityte A, Montrimaite M, Kaselis N, Strazdas A, Jokubonis K, Maceviciute K, Beisa V, Poskus T, Strupas K, Laugzemys E, Kolosov A, Jotautas V, Rakita I, Mikalauskas S, Kazanavicius D, Rackauskas R, Strupas K, Poskus T, Beisa V, Rakauskas R, Preckailaite E, Coomber R, Johnson K, Nowers J, Periasammy D, Salleh A, Das A, Tze RGE, Kumar MN, Abdullah NAN, Kosai NR, Taher M, Rajan R, Chong HY, Roslani AC, Goh CC, Agius M, Borg E, Bezzina M, Bugeja R, Vella-Baldacchino M, Spina A, Psaila J, Francois-Coridon H, Tolg C, Colombani JF, Diaz-Zorrilla, De La Medina AR, Gonzalez SC, Jacobe M, Mapasse D, Snyder E, Oumer R, Osman M, Mohammad A, Anyanwu LJ, Sheshe A, Adesina A, Faturoti O, Taiwo O, Ibrahim MH, Nasir AA, Suleiman SI, Adeniyi A, Adesanya O, Adebanjo A, Osuoji R, Atobatele K, Ogunyemi A, Williams O, Oludara M, Oshodi O, Ademuyiwa A, Lawal AO, Alakaloko F, Elebute O, Osinowo A, Bode C, Adesuyi A, Tade A, Adekoya A, Nwokoro C, Ayandipo OO, Lawal TA, Ajao AE, Ali SS, Odeyemi B, Olori S, Popoola A, Adeyeye A, Adeniran J, Lossius WJ, Havemann I, Thorsen K, Narvestad JK, Soreide K, Wold TB, Nymo L, Elsiddig M, Dar M, Bhopal KF, Iftikhar Z, Furqan MM, Nighat B, Jawaid M, Khalique A, Zil-E-Ali A, Rashid A, Dharamshi HA, Naqvi T, Faraz A, Anwar AW, Yaseen TM, Shamsi GS, Shamsi G, Yaseen T, Anwer W, Decoud HP, Aguilera O, Alvarez IIZ, Delgado JM, Vega GMM, Lohse HAS, Aguilar WLM, Chiong JAC, Bautista ACM, Huaman E, Zegarra S, Camacho R, Celis JMV, Pozo DAR, Hamasaki J, Temoche E, Herrera-Matta J, Torres CPG, Barreda LMA, Ojeda RRB, Garaycochea O, Mollo MC, Delgado MSFTL, Fujii F, Bautista ACM, Aguilar WLM, Chiong JAC, Durand SYA, Basto CAA, Rojas NMU, Yip SBS, Vergara ALC, Moran AER, Luque GB, Castro MR, Jaramillo RA, Sila GM, Lopez CE, De Leon MZP, Machaca M, Huaraya RC, Arenas A, López C, Puma CMH, Pino W, Hinojosa C, De Leon MZP, Limache S, Sila GM, Rodriguez LM, Melo R, Costa-Maia J, Muralha N, Sauvat F, Dan I, Hogea M, Eduard P, Bratu RM, Beuran M, Diaconescu IB, Martian BV, Iordache FM, Vartic M, Vida LC, Muntean LI, Mironescu AS, Nsengimana VJP, Niragire A, Ingabire JCA, Niyirera E, Zanini N, Jovine E, Landolfo G, Alomar IN, Alnuqaydan SA, Altwigry AM, Othman M, Osman N, Alqahtani E, Alzahrani M, Alyami R, Aljohani E, Alhabli I, Mikwar Z, Almuallem S, Aljohani E, Alyami R, Alzahrani M, Nawawi A, Bakhaidar M, Maghrabi AA, Alsaggaf M, Aljiffry M, Altaf A, Khoja A, Habeebullah A, Akeel N, Ghandora N, Almoflihi A, Huwait A, Al-Shammari A, Al-Mousa M, Alghamdi M, Adham W, Albeladi B, Alfarsi MA, Mahdi A, Al Awwad S, Altamimi A, Nouh T, Hassanain M, Aldhafeeri S, Sadig N, Algohary O, Aledrisy M, Gudal A, Alrifaie A, AlRowais M, Althwainy A, Shabkah A, Alamoudi U, Alrajraji M, Alghamdi B, Aljohani S, Daqeeq A, Al-Faifi JJ, Jennings V, Ngayu N, Moore R, Kong V, Kretzmann H, Connor K, Nel D, Sampson C, Spence R, Panieri E, Rayne S, Sishuba N, Tun M, Mphatsoe AM, Carreira JA, Teasdale E, Wagener M, Botes S, Du Plessis D, Fernandez-Bueno F, Aguilar-Jimenez J, Garcia-Marin JA, García LS, Florez LJG, Pacheco RDA, Pagnozzi J, Quezada JHJ, Rodicio JL, Minguez G, Rodríguez-Uría R, Ugalde P, Lopez-Arevalo C, Barneo L, Stuva JPG, Ortega-Vazquez I, Rodriguez L, Herrera N, Arachchi PP, Senanayake WSMKJ, Arachchige LAJJ, Sivaganesh S, Samaraweera DI, Thanusan V, Musa AEK, Balila RMH, Mohamed MAEH, Ali H, Elabdin HZ, Hassan A, Mahdi S, Ahmed H, Idris SAI, Elsayed M, Elsayed M, Mahmoud M, Boijsen M, Lundgren PO, Gustafsson U, Kiasat A, Wogensen F, Wogensen F, Jurdell E, Thorell A, Thorarinsdottir H, Utter M, Sundstrom SM, Wredberg C, Kjellin A, Nyberg J, Frisk B, Sund M, Andersson L, Gunnarsson U, Cengiz Y, Ahlqvist S, Royson IBH, Weber P, Pahlsson HI, Borin E, Hjertberg M, Royson H, Weber P, Schmid R, Schivo D, Despotidis V, Breitenstein S, Staerkle RF, Schadde E, Deichsel F, Gerosa A, Nocito A, Raptis DA, Mijuskovic B, Zuber M, Eisner L, Kruspi S, Reinisch KB, Schoewe C, Novak A, Palma AF, Teufelberger G, Kimaro M, King R, Balkan AZA, Gumar M, Yavuz MA, Karabacak U, Lap G, Ozkan BB, Ozkan BB, Karakahya M, Adams R, Morton R, Henderson L, Gratton R, Clement KD, Chang KY, Mcnish D, Mcintosh R, Milligan W, Skelly B, Anderson-Knight H, Lawther R, Onimowo J, Shatkar V, Tharmalingam S, Woin E, Fautz T, Ziff O, Dindyal S, Arman S, Talukder S, Arman S, Gadhvi V, Talukder S, Chew LS, Heath J, Blencowe N, Hallam S, Gash K, Mannu GS, Zachariades DC, Snaith AC, Hettiarachchi TS, Nesaratnam A, Wheeler J, McCullagh D, Clements JM, Khan A, Koumpa F, Neophytou C, Roth J, Soon WC, Deputy M, Ahmed A, Ashton A, Vincent J, Almy J, Khan T, Allen JLY, Mcintyre CJ, Marshall DC, Sykes M, Behar N, Jordan H, Rajjoub Y, Sherman T, White T, Watts A, Ardley R, Arulampalam T, Shah A, Brown D, Blower E, Sutton P, Gasteratos K, Vimalachandran D, Magee C, Irwin G, Mcguigan A, Mcaleer S, Morgan C, Braungart S, Lafferty K, Labib P, Tanase A, Mangan C, Reza L, Reza L, Tanase A, Mangan C, Woodward H, Gouldthorpe C, Turner M, Wild JRL, Malik TA, Proctor VK, Hewage K, Davies J, Dubois A, Sarwary S, Zardab A, Grant A, Mcintyre R, Mogan YP, Ho W, Chong BFHK, Tewari S, Humm G, Hall EFNJ, Wright NJ, Major CP, Xerri T, De Bono P, Amin J, Farhad M, Camilleri-Brennan JF, Robertson AGN, Xerri T, Swann J, Richards J, Amin J, Jabbar A, De Bono P, Attard M, Burns H, Macdonald E, Baldacchino M, Skehan J, Camilleri-Brennan J, Hall TF, Gimzewska M, Mclachlan G, Shah J, Giles J, Chiu S, Weber B, Chiu SMY, Highcock S, Hassan M, Beasley W, Vlachogiorgos A, Dias S, Maharaj G, Mcdonald R, Macdonald A, Witherspoon P, Baird A, Sarmah P, Green N, Youssef H, Cross K, Rees CM, Van Duren B, Upchurch E, Khan K, Abudeeb H, Hammad A, Karandikar S, Bowley D, Karim A, Chachulski W, Richardson L, Dawnay G, Thompson B, Mistry A, Bhangu A, Ghetia M, Roy S, Al-Obaedi O, Ghetia M, Das K, Prabhudesai A, Cocker DM, Tan JJ, Tyler R, Di Franco F, Ayyar S, Vivekanantham S, Gokani S, Gillespie M, Gudlaugsdottir K, Pezas T, Currow C, Kim MY, Birring A, Edwards J, Ali A, Das S, Jha M, Atkinson K, Luck J, Fozard T, Puttick M, Salama Y, Shah R, Ibrahem AA, Ebdewi H, Gravante G, El-Rabaa S, Nnajiuba H, Allott R, Bhargava A, Chan Z, Hassan Z, Makinde M, Hemingway D, Dean R, Boddy A, Aber A, Patel V, Parakh J, Parthiban S, Ubhi HK, Hosein SP, Ward S, Malik K, Jennings L, Newton T, Alkhouri M, Kang MK, Houlden C, Barry J, Raza I, Farquharson A, Bhattacharya S, Milligan W, Chang K, Henderson L, Wilson MSJ, Neo YN, Ibrahim I, Chan E, Peck FS, Lim PJ, North AS, Blundell R, Williamson A, Fouad D, Minocha A, Mccarthy K, Court E, Chambers A, Yee J, Tham JC, Beaton C, Walsh U, Lockey J, Bokhari S, Howells L, Griffiths M, Yallop L, Singh S, Nasher O, Jackson P, Puttick M, Luck J, Fozard T, Shariffuddin AM, Ho WC, Wilson MS, Pabla G, Ramzi S, Zeidan S, Doughty J, Sinha S, Davenport R, Lewis J, Duffy L, Mcaleer E, Williams E, Som R, Javed O, Boal M, 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Abstract

BACKGROUND:

The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy.

METHODS:

In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation.

RESULTS:

Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P < 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P < 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -9·4 (95 per cent c.i. -11·9 to -6·9) per cent; P < 0·001), but the relationship was reversed in low-HDI countries (+12·1 (+7·0 to +17·3) per cent; P < 0·001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0·60, 0·50 to 0·73; P < 0·001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries.

CONCLUSION:

Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.

PMID:
30620059
PMCID:
PMC6492154
DOI:
10.1002/bjs.11051
[Indexed for MEDLINE]
Free PMC Article

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