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Br J Anaesth. 2016 Oct 31;117(5):601-609. doi: 10.1093/bja/aew316.

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

Collaborators (2751)

Pearse RM, Beattie S, Clavien PA, Demartines N, Fleisher LA, Grocott M, Haddow J, Hoeft A, Holt P, Moreno R, Pritchard N, Rhodes A, Wijeysundera D, Wilson M, Ahmed T, Everingham K, Hewson R, Januszewska M, Pearse RM, Phull MK, Halliwell R, Shulman M, Myles P, Schmid W, Hiesmayr M, Wouters P, de Hert S, Lobo S, Beattie S, Wijeysundera D, Fang X, Rasmussen L, Futier E, Biais M, Venara A, Slim K, Sander M, Koulenti D, Arvaniti K, Chan M, Kulkarni A, Chandra S, Tantri A, Geddoa E, Abbas M, Rocca GD, Sivasakthi D, Mansor M, Luna P, Bouwman A, Buhre W, Beavis V, Campbell D, Short T, Osinaike T, Matos R, Grigoras I, Kirov M, Protsenko D, Biccard B, Aldecoa C, Chew M, Hofer C, Hubner M, Ditai J, Szakmany T, Fleisher L, Ferguson M, MacMahon M, Shulman M, Cherian R, Currow H, Kanathiban K, Gillespie D, Pathmanathan E, Phillips K, Reynolds J, Rowley J, Douglas J, Kerridge R, Currow H, Garg S, Bennett M, Jain M, Alcock D, Terblanche N, Cotter R, Leslie K, Stewart M, Zingerle N, Clyde A, Hambidge O, Rehak A, Cotterell S, Quan Huynh WB, McCulloch T, Ben-Menachem E, Egan T, Cope J, Halliwell R, Fellinger P, Haisjackl M, Haselberger S, Holaubek C, Lichtenegger P, Scherz F, Schmid W, Hoffer F, Cakova V, Eichwalder A, Fischbach N, Klug R, Schneider E, Vesely M, Wickenhauser R, Grubmueller KG, Leitgeb M, Lang F, Toro N, Bauer M, Laengle F, Haberl C, Mayrhofer T, Trybus C, Buerkle C, Forstner K, Germann R, Rinoesl H, Schindler E, Trampitsch E, Bogner G, Dankl D, Duenser M, Fritsch G, Gradwohl-Matis I, Hartmann A, Hoelzenbein T, Jaeger T, Landauer F, Lindl G, Lux M, Steindl J, Stundner O, Szabo C, Bidgoli J, Verdoodt H, Forget P, Kahn D, Lois F, Momeni M, Prégardien C, Pospiech A, Steyaert A, Veevaete L, De Kegel D, De Jongh K, Foubert L, Smitz C, Vercauteren M, Poelaert J, Van Mossevelde V, Abeloos J, Bouchez S, Coppens M, De Baerdemaeker L, Deblaere I, De Bruyne A, De Hert S, Fonck K, Heyse B, Jacobs T, Lapage K, Moerman A, Neckebroek M, Parashchanka A, Roels N, Van Den Eynde N, Vandenheuvel M, Limmen J, Vanluchene A, Vanpeteghem C, Wouters P, Wyffels P, Huygens C, Vandenbempt P, Van de Velde M, Dylst D, Janssen B, Schreurs E, Aleixo FB, Candido K, Batista HD, Guimarães M, Guizeline J, Hoffmann J, Lobo S, Lobo FRM, Nascimento V, Nishiyama K, Pazetto L, Souza D, Rodrigues RS, Dos Santos AMV, Jardim J, Sá Malbouisson LM, Silva J, Nascimento Junior PD, Baio TH, de Castro GIP, Watanabe Oliveira HR, Amendola CP, Cardoso G, Ortega D, Brotto AF, De Oliveira MC, Réa-Neto Á, Dias F, Travi ME, Zerman L, Azambuja P, Knibel MF, Martins A, Almeida W, Neto CN, Tardelli MA, Caser E, Machado M, Aguzzoli C, Baldisserotto S, Tabajara FB, Bettega F, Rodrigues Júnior HC, de Gasperi J, Faina L, Nolasco MF, da Costa Fischer BF, de Campos Ferreira MF, Hartmann C, Kliemann M, Hubert Ribeiro GL, Fraga JM, Netto TM, Pozza LV, Wendling PR, Azevedo C, Garcia J, Lopes M, Maia B, Maselli P, Melo R, Mendes W, Neves M, Ney J, Piras C, Applewhaite C, Carr A, Chow L, Duttchen K, Foglia J, Greene M, Hinther A, Houston K, McCormick TJ, Mikhayel J, Montasser S, Ragan A, Suen A, Woolsey A, Yu HC, Funk D, Kowalski S, Legaspi R, McDonald H, Siddiqui F, Pridham J, Rowe B, Sampson S, Thiessen B, Zbitnew G, Bernard A, George R, Jones P, Moor R, Siddiqui N, Wolfer A, Tran D, Winch D, Dobson G, Hinther A, McCormick T, Montasser O, Suen A, Woolsey A, Bernard A, George R, Hall R, Bernard A, George R, Hall R, Applewhaite C, Baghirzada L, McCormick TJ, Suen A, Curley G, Dai SY, Hare G, Lee E, Shastri U, Tsui A, Yagnik A, Alvares D, Choi S, Dwyer H, Flores K, McCartney C, Somascanthan P, Beattie S, Carroll J, Pazmino-Canizares J, Wijeysundera D, Wolfer A, Ami N, Chan V, Perlas A, Argue R, Huang Y, Lavis K, Mayson K, Cao Y, Gao H, Hu T, Lv J, Yang J, Yang Y, Zhong Y, Zhou J, Zou X, He M, Li X, Luo D, Wang H, Yu T, Chen L, Wang L, Cai Y, Cao Z, Li Y, Lian J, Sun H, Wang S, Wang Z, Wang K, Zhu Y, Du X, Fan H, Fu Y, Huang L, Huang Y, Hwan H, Luo H, Qu PS, Tao F, Wang Z, Wang G, Wang S, Zhang Y, Zhang X, Chen C, Wang W, Liu Z, Fan L, Tang J, Chen Y, Chen Y, Han Y, Huang C, Liang G, Shen J, Wang J, Yang Q, Zhen J, Zhou H, Chen J, Chen Z, Li X, Meng B, Ye H, Zhang X, Bi Y, Cao J, Guo F, Lin H, Liu Y, Lv M, Shi P, Song X, Sun C, Sun Y, Wang Y, Wang S, Zhang M, Chen R, Hou J, Leng Y, Meng QT, Qian L, Shen ZY, Xia ZY, Xue R, Zhang Y, Zhao B, Zhou XJ, Chen Q, Guo H, Guo Y, Qi Y, Wang Z, Wei J, Zhang W, Zheng L, Bao Q, Chen Y, Chen Y, Fei Y, Hu N, Hu X, Lei M, Li X, Lv X, Lv J, Miao F, Ouyang L, Qian L, Shen C, Sun Y, Wang Y, Wang D, Wu C, Xu L, Yuan J, Zhang L, Zhang H, Zhang Y, Zhao J, Zhao C, Zhao L, Zheng T, Zhou D, Zhou H, Zhou C, Lu K, Zhao T, He C, Chen H, Chen S, Cheng B, He J, Jin L, Li C, Li H, Pan Y, Shi Y, Wen XH, Wu S, Xie G, Zhang K, Zhao B, Lu X, Chen F, Liang Q, Lin X, Ling Y, Liu G, Tao J, Yang L, Zhou J, Chen F, Cheng Z, Dai H, Feng Y, Hou B, Gong H, Hu CH, Huang H, Huang J, Jiang Z, Li M, Lin J, Liu M, Liu W, Liu Z, Liu Z, Luo F, Ma L, Min J, Shi X, Song Z, Wan X, Xiong Y, Xu L, Yang S, Zhang Q, Zhang H, Zhang H, Zhang X, Zhao L, Zhao W, Zhao W, Zhu X, Bai Y, Chen L, Chen S, Dai Q, Geng W, Han K, He X, Huang L, Ji B, Jia D, Jin S, Li Q, Liang D, Luo S, Lwang L, Mo Y, Pan Y, Qi X, Qian M, Qin J, Ren Y, Shi Y, Wang J, Wang J, Wang L, Xie J, Yan Y, Yao Y, Zhang M, Zhao J, Zhuang X, Ai Y, Du F, He L, Huang L, Li Z, Li H, Li Y, Li L, Meng S, Yuan Y, Zhang E, Zhang J, Zhao S, Ji Z, Pei L, Wang L, Chen C, Dong B, Li J, Miao Z, Mu H, Qin C, Su L, Wen Z, Xie K, Yu Y, Yuan F, Hu X, Zhang Y, Xiao W, Zhu Z, Dai Q, Fu K, Hu R, Hu X, Huang S, Li Y, Liang Y, Yu S, Guo Z, Jing Y, Tang N, Wu J, Yuan D, Zhang R, Zhao X, Li Y, Bai HP, Liu CX, Liu FF, Ren W, Wang XL, Xu GJ, Hu N, Li B, Ou Y, Tang Y, Yao S, Zhang S, Kong CC, Liu B, Wang T, Xiao W, Lu B, Xia Y, Zhou J, Cai F, Chen P, Hu S, Wang H, Wu J, Xu Q, Hu L, Jing L, Li J, Li B, Liu Q, Liu Y, Lu X, Peng ZD, Qiu X, Ren Q, Tong Y, Wang Z, Wang J, Wen Y, Wu Q, Xia J, Xie J, Xiong X, Xu S, Yang T, Ye H, Yin N, Yuan J, Zeng Q, Zhang B, Zheng K, Cang J, Chen S, Du F, Fan Y, Fu S, Ge X, Guo B, Huang W, Jiang L, Jiang X, Jin L, Liu Y, Pan Y, Ren Y, Shan Q, Wang J, Wang F, Wu C, Zhang X, Christiansen IC, Granum SN, Rasmussen BS, Daugaard M, Gambhir R, Brandsborg B, Steingrímsdóttir GE, Jensen-Gadegaard P, Olsen KS, Siegel H, Eskildsen KZ, Gätke MR, Wibrandt I, Heintzelmann SB, Lange KHW, Lundsgaard RS, Amstrup-Hansen L, Hovendal C, Larsen M, Lenstrup M, Kobborg T, Larsen JR, Pedersen AB, Larsen JR, Smith SH, Oestervig RM, Rasmussen L, Afshari A, Andersen C, Ekelund K, Secher EL, Brandsborg B, Beloeil H, Lasocki S, Venara A, Biais M, Ouattara A, Sineus M, Molliex S, Legouge ML, Wallet F, Tesniere A, Gaudin C, Lehur P, Forsans E, de Rudnicki S, Maudet VS, Mutter D, Sojod G, Ouaissi M, Regimbeau JM, Futier E, Desbordes J, Comptaer N, El Manser D, Ethgen S, Lebuffe G, Auer P, Härtl C, Deja M, Legashov K, Sonnemann S, Wiegand-Loehnert C, Falk E, Habicher M, Angermair S, Laetsch B, Schmidt K, Sonnemann S, Von Heymann C, Ramminger A, Jelschen F, Pabel S, Weyland A, Czeslick E, Gille J, Malcharek M, Sablotzki A, Lueke K, Wetzel P, Weimann J, Lenhart FP, Reichle F, Schirmer F, Hüppe M, Klotz K, Nau C, Schön J, Mencke T, Wasmund C, Bankewitz C, Baumgarten G, Fleischer A, Guttenthaler V, Hack Y, Hoeft A, Kirchgaessner K, Männer O, Schurig-Urbaniak M, Struck R, van Zyl R, Wittmann M, Goebel U, Harris S, Veit S, Andreadaki E, Souri F, Katsiadramis I, Skoufi A, Vasileiou M, Aimoniotou-Georgiou E, Katsourakis A, Veroniki F, Vlachogianni G, Petra K, Chlorou D, Oloktsidou E, Ourailoglou V, Papapostolou K, Tsaousi G, Daikou P, Dedemadi G, Kalaitzopoulos I, Loumpias C, Bristogiannis S, Dafnios N, Gkiokas G, Kontis E, Kozompoli D, Papailia A, Theodosopoulos T, Bizios C, Koutsikou A, Moustaka A, Plaitakis I, Armaganidis A, Christodoulopoulou T, Lignos M, Theodorakopoulou M, Asimakos A, Ischaki E, Tsagkaraki A, Zakynthinos S, Antoniadou E, Koutelidakis I, Lathyris D, Pozidou I, Voloudakis N, Dalamagka M, Elena G, Chronis C, Manolakaki D, Mosxogiannidis D, Slepova T, Tsakiridou IS, Lampiri C, Vachlioti A, Panagiotakis C, Sfyras D, Tsimpoukas F, Tsirogianni A, Axioti E, Filippopoulos A, Kalliafa E, Kassavetis G, Katralis P, Komnos I, Pilichos G, Ravani I, Totis A, Apagaki E, Efthymiadi A, Kampagiannis N, Paraforou T, Tsioka A, Georgiou G, Vakalos A, Bairaktari A, Charitos E, Markou G, Niforopoulou P, Papakonstantinou N, Tsigou E, Xifara A, Zoulamoglou M, Gkioni P, Karatzas S, Kyparissi A, Mainas E, Papapanagiotou I, Papavasilopoulou T, Fragandreas G, Georgopoulou E, Katsika E, Psarras K, Synekidou E, Verroiotou M, Vetsiou E, Zaimi D, Anagnou A, Apostolou K, Melissopoulou T, Rozenberg T, Tsigris C, Boutsikos G, Kalles V, Kotsalas N, Lavdaiou C, Paikou F, Panagou GL, Spring A, Arvaniti K, Botis I, Drimala M, Georgakakis G, Kiourtzieva E, Ntouma P, Prionas A, Xouplidis K, Dalampini E, Giannaki C, Iasonidou C, Ioannidis O, Lavrentieva A, Lavrentieva A, Papageorgiou G, Kokkinoy M, Stafylaraki M, Gaitanakis S, Karydakis P, Paltoglou J, Ponireas P, Chaloulis P, Provatidis A, Sousana A, Gardikou VV, Konstantivelli M, Lataniotou O, Lisari E, Margaroni M, Stamatiou K, Nikolaidis E, Pnevmatikos I, Sertaridou E, Andreou A, Arkalaki E, Athanasakis E, Chaniotaki F, Chatzimichali CA, Christofaki M, Dermitzaki D, Fiorentza K, Frantzeskos G, Geromarkaki E, Kafkalaki K, Kalogridaki M, Karydi K, Kokkini S, Kougentakis G, Lefaki T, Lilitsis E, Makatounaki A, Malliotakis P, Michelakis D, Neonaki M, Nyktari V, Palikyra I, Papadakis E, Papaioannou A, Sfakianakis K, Sgouraki M, Souvatzis X, Spartinou A, Stefanidou N, Syrogianni P, Tsagkaraki G, Arnaoutoglou E, Arnaoutoglou C, Bali C, Bouris V, Doumos R, Gkini KP, Kapaktsi C, Koulouras V, Lena A, Lepida D, Michos E, Papadopoulos D, Paschopoulos M, Rompou VA, Siouti I, Tsampalas S, Ververidou O, Zilis G, Charlalampidoy A, Christodoulidis G, Flossos A, Stamoulis K, Chan M, Tsang MSC, Tsang MS, Lai ML, Yip CP, Chan HMH, Law B, Li WS, Chu HM, Koo EGY, Lam CCJ, Cheng KH, Chan M, Lam T, Chu S, Lai ML, Lam WY, Wong KWK, Kwok D, Hung CYJ, Chan WKJ, LamWong W, Chung CKE, Lai ML, Ma SK, Kaushik S, Shah B, Shah D, Shah S, Ar P, Muthuchellappan R, Agarwal V, Divatia J, Kulkarni A, Mishra S, Nimje G, Pande S, Savarkar S, Shrivastava A, Thomas M, Yegnaram S, Hidayatullah R, Chandra S, Tantri A, Puar N, Niman S, Indra I, Hamzah Z, Yuliana A, Abidin UN, Dursin AN, Kurnia A, Susanti A, Handayani D, Alit MA, Arya A, Senapathi TGA, Utara UH, Wid WM, Wima S, Wir WM, Jehosua B, Kaunang J, Lantang EY, Najoan R, Waworuntu N, Awad H, Fuad A, Geddoa E, Geddoa B, Khalaf AR, Al Hussaini S, Albaj S, Kenber M, Bettinelli A, Spadaro S, AlbertoVolta C, Giancarlo L, Sottosanti V, Copetti E, Rocca GD, Spagnesi L, Toretti I, Alloj C, Cardellino S, Carmino L, Costanzo E, Fanfani LC, Novelli MT, Roasio A, Bellandi M, Beretta L, Bignami E, Bocchino S, Cabrini L, Corti D, Landoni G, Meroni R, Moizo E, Monti G, Pintaudi M, Plumari VP, Taddeo D, Testa V, Winterton D, Zangrillo A, Cloro LM, Colangelo C, Colangelo A, Rotunno G, Paludi MA, Maria CP, Pata A, Parrini V, Gatta A, Nastasi M, Tinti C, Baroselli A, Spagnesi L, Arrigo M, Benevento A, Bottini C, Cannavo' M, Gastaldi C, Marchesi A, Pascazio A, Pata F, Pozzi E, Premoli A, Tessera G, Boschi L, D'Andrea R, Ghignone F, Poggioli G, Sibilio A, Taffurelli M, Ugolini G, Ab Majid MA, Ab Rahman R, Joseph J, Pathan F, Shah MHS, Yap HL, Cheah S, Chin II, Looi JK, Tan SC, Visvalingam S, Kwok FY, Lee CK, Tan TS, Wong SM, Abdullah NH, Liew CF, Luxuman L, Zin NHM, Norddin MF, Alias RLR, Wong JY, Yong J, Mustapha MTB, Chan WK, Dzulkipli N, Kuan PX, Lee YC, Alias A, Guok EC, Jee CC, Ramon BR, Wong CW, Abd Ghafar FNI, Aziz FZ, Hussain N, Lee HS, Sukawi I, Woon YL, Abd Hadi HZ, Ahmad Azam UA, Alias AH, Kesut SA, Lee JM, Ooi DV, Sulaiman HA, Lih TAT, Mansor M, Veerakumaran J, Luna P, Rojas E, Resendiz GEA, Zapata DDM, Aguilar López JCJ, Flores AAA, Amador JCB, Avila EJD, Aquino LPG, Rodriguez RL, Landa MT, Urias E, Hollmann M, Hulst A, Preckel OKB, Gemert AK, Bouwman A, Buise M, Tolenaar N, Weber E, de Fretes J, Houweling P, Ormskerk P, Van Bommel J, Buhre W, Lance M, Smit-Fun V, van Zundert T, Baas P, de Boer HD, Sprakel J, Elferink-Vonk R, Noordzij P, van Zeggeren L, Brand B, Spanjersberg R, Andela JTB, Numan S, van Klei W, van Zaane B, Boer C, van Duivenvoorde Y, Hering JP, van Rossum S, Zonneveldt H, Campbell D, Hoare S, Santa S, Ali M, Allen SJ, Beavis V, Bell R, Campbell D, Choi HD, Drake M, Farrell H, Hayes K, Higgie K, Holmes K, Jenkins N, Kim CJ, Kim S, Law KC, McAllister D, Park K, Pedersen K, Pfeifer L, Pozaroszczyk A, Salmond T, Steynor M, Tan M, Short T, Waymouth E, Ab Rahman AS, Armstrong J, Dudson R, Jenkins N, Nilakant J, Richard S, Virdi P, Dixon L, Donohue R, Farrow M, Kennedy R, Marissa H, McKellow M, Nicola D, Pascoe R, Roberts SJ, Rowell G, Sumner M, Templer P, Chandrasekharan S, Fulton G, Jammer I, Ali M, More R, Wilson L, Chang YH, Foley J, Fowler C, Panckhurst J, Sara R, Stapelberg F, Campbell D, Cherrett V, Ganter DL, McAllister D, McCann L, Foley J, Gilmour F, Lumsden R, Moores M, Olliff S, Sardareva E, Stapelberg F, Tai J, Wikner M, Wong C, Chaddock M, Czepanski C, McKendry P, Polakovic D, Polakovich D, Robert A, Belda MT, Norton T, Stapelberg F, Alherz F, Barneto L, Ramirez A, Sayeed A, Smith N, Bennett C, McQuoid S, Bell R, Jansen TL, Nico Z, Scott J, Freschini D, Freschini A, Hopkins B, Manson L, Stoltz D, Bates A, Davis S, Freeman V, McGaughran L, Williams M, Sharma SB, Burrows T, Byrne K, English D, Johnson R, Law KC, Manikkam B, McAllister D, Naidoo S, Rumball M, Whittle N, Franks R, Gibson-Lapsley H, McAllister D, Salter R, Walsh D, Cooper R, Perry K, Obobolo A, Sule UM, Ahmad A, Atiku M, Mohammed AD, Sarki AM, Adekola O, Akanmu O, Durodola A, Olukoju O, Raji V, Olajumoke T, Oyebamiji E, Adenekan A, Adetoye A, Faponle F, Olateju S, Owojuyigbe A, Talabi A, Adenike O, Adewale B, Collins N, Ezekiel E, Fatungase OM, Grace A, Sola S, Stella O, Ademola A, Adeolu AA, Adigun T, Akinwale M, Fasina O, Gbolahan O, Idowu O, Olonisakin RP, Osinaike BB, Asudo F, Mshelia D, Abdur-Rahman L, Agodirin O, Bello J, Bolaji B, Oyedepo OO, Ezike H, Iloabachie I, Okonkwo I, Onuora E, Onyeka T, Ugwu I, Umeh F, Alagbe-Briggs O, Dodiyi-Manuel A, Echem R, Obasuyi B, Onajin-Obembe B, Bandeira ME, Martins A, Tom M, Martins Costa ACM, Krystopchuk A, Branco T, Esteves S, Melo MA, Monte J, Rua F, Martins I, Pinho-Oliveira VM, Rodrigues CM, Cabral R, Marques S, Rêgo S, Jesus JST, Marques MC, Romao C, Dias S, Santos AM, Alves MJ, Salta C, Cruz S, Duarte C, Furtado Paiva AA, do Nascimento Cabral T, Dionisio FEM, Correia da Silva RFM, Langner A, Resendes HO, Soares MDC, Abrunhosa A, Faria F, Miranda L, Pereira H, Serra S, Ionescu D, Margarit S, Mitre C, Vasian H, Manga G, Stefan A, Tomescu D, Filipescu D, Paunescu MA, Stefan M, Stoica R, Gavril L, Pătrăşcanu E, Ristescu I, Rusu D, Diaconescu C, Iosep GF, Pulbere D, Ursu I, Balanescu A, Grintescu I, Mirea L, Rentea I, Vartic M, Lupu MN, Stanescu D, Streanga L, Antal O, Hagau N, Patras D, Petrisor C, Tosa F, Tranca S, Copotoiu SM, Ungureanu LL, Harsan CR, Papurica M, Cernea DD, Dragoescu NA, Aflori L, Vaida C, Ciobotaru OR, Aignatoaie M, Carp CP, Cobzaru I, Mardare O, Purcarin B, Tutunaru V, Ionita V, Arustei M, Codita A, Busuioc M, Chilinciuc I, Ciobanu C, Belciu I, Tincu E, Blaj M, Grosu RM, Sandu G, Bruma D, Corneci D, Dutu M, Krepil A, Copaciu E, Dumitrascu CO, Jemna R, Mihaescu F, Petre R, Tudor C, Ursache E, Kulikov A, Lubnin A, Grigoryev E, Pugachev S, Protsenko D, Tolmasov A, Hussain A, Ilyina Y, Kirov M, Roshchina A, Iurin A, Chazova E, Dunay A, Karelov A, Khvedelidze I, Voldaeva O, Belskiy V, Dzhamullaev P, Grishkowez E, Kretov V, Levin V, Molkov A, Puzanov S, Samoilenko A, Tchekulaev A, Tulupova V, Utkin I, Allorto NL, Bishop DG, Builu PM, Cairns C, Dasrath A, de Wet J, den Hoedt M, Grey B, Hayes MP, Küsel BS, Shangase N, Wise R, Cacala S, Farina Z, Govindasamy V, Kruse CH, Lee C, Marais L, Naidoo TD, Rajah C, Rodseth RN, Ryan L, von Rhaden R, Adam S, Alphonsus C, Ameer Y, Anderson F, Basanth S, Bechan S, Bhula C, Biccard BM, Biyase T, Buccimazza I, Cardosa J, Chen J, Daya B, Drummond L, Elabib A, Goad EHA, Goga IE, Goga R, Harrichandparsad R, Hodgson RE, Jordaan J, Kalafatis N, Kampik C, Landers AT, Loots E, Madansein R, Madaree A, Madiba TE, Manzini VT, Mbuyisa M, Moodley R, Msomi M, Mukama I, Naidoo D, Naidoo R, Naidu TK, Ntloko S, Padayachee E, Padayachee L, Phaff M, Pillay B, Pillay D, Pillay L, Ramnarain A, Ramphal SR, Ryan P, Saloojee A, Sebitloane M, Sigcu N, Taylor JL, Torborg A, Visser L, Anderson P, Conradie A, de Swardt M, de Villiers M, Eikman J, Liebenberg R, Mouton J, Paton A, van der Merwe L, Wilscott-Davids C, Barrett WJ, Bester M, de Beer J, Geldenhuys J, Gouws H, Potgieter JH, Strydom M, WilberforceTurton E, Chetty RR, Chirkut S, Cronje L, Vasconcellos K, Dube NZ, Gama NS, Green GM, Green-Thompson R, 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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 a median 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.

STUDY REGISTRATION:

ISRCTN51817007

KEYWORDS:

cohort studies; critical care/utilisation; operative/mortality; postoperative care/methods; postoperative care/statistics and numerical data; surgery; surgical procedures

PMID:
27799174
PMCID:
PMC5091334
DOI:
10.1093/bja/aew316
[Indexed for MEDLINE]
Free PMC Article

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