Mortality after surgery in Europe: a 7 day cohort study
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 intern...
Published in: | The Lancet |
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2012
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Online Access: | http://hdl.handle.net/2078.1/118521 https://doi.org/10.1016/S0140-6736(12)61148-9 |
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ftunivlouvain:oai:dial.uclouvain.be:boreal:118521 2024-05-19T07:43:03+00:00 Mortality after surgery in Europe: a 7 day cohort study Pearse, Rupert M Moreno, Rui P Bauer, Peter Pelosi, Paolo Metnitz, Philipp Spies, Claudia Vallet, Benoit Vincent, Jean-Louis De Kock, Marc Hoeft, Andreas Rhodes, Andrew Georges, Pascal Grosu, Irina Kahn, David Lois, Fernande Momeni, Mona Pospiech, Audrey Yemnga, Bernadette Bosinceanu, Dana Collard, Edith European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology. Forget, Patrice UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire UCL - SSS/IREC/MEDA - Pôle de médecine aiguë UCL - SSS/IONS/NEUR - Clinical Neuroscience UCL - (SLuc) Service d'anesthésiologie 2012 http://hdl.handle.net/2078.1/118521 https://doi.org/10.1016/S0140-6736(12)61148-9 eng eng TheLancet Publishing Group boreal:118521 http://hdl.handle.net/2078.1/118521 doi:10.1016/S0140-6736(12)61148-9 info:pmid/22998715 urn:ISSN:0140-6736 urn:EISSN:1474-547X info:eu-repo/semantics/openAccess The Lancet, Vol. 380, no. 9847, p. 1059-1065 (2012) Adult Length of Stay Male Middle Aged Postoperative Care Surgical Procedures Operative Treatment Outcome Aged Cohort Studies Critical Care Europe Female Hospital Mortality Hospitalization Humans info:eu-repo/semantics/article 2012 ftunivlouvain https://doi.org/10.1016/S0140-6736(12)61148-9 2024-04-24T01:40:39Z 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 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. 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 ... Article in Journal/Newspaper Iceland DIAL@UCLouvain (Université catholique de Louvain) The Lancet 380 9847 1059 1065 |
institution |
Open Polar |
collection |
DIAL@UCLouvain (Université catholique de Louvain) |
op_collection_id |
ftunivlouvain |
language |
English |
topic |
Adult Length of Stay Male Middle Aged Postoperative Care Surgical Procedures Operative Treatment Outcome Aged Cohort Studies Critical Care Europe Female Hospital Mortality Hospitalization Humans |
spellingShingle |
Adult Length of Stay Male Middle Aged Postoperative Care Surgical Procedures Operative Treatment Outcome Aged Cohort Studies Critical Care Europe Female Hospital Mortality Hospitalization Humans Pearse, Rupert M Moreno, Rui P Bauer, Peter Pelosi, Paolo Metnitz, Philipp Spies, Claudia Vallet, Benoit Vincent, Jean-Louis De Kock, Marc Hoeft, Andreas Rhodes, Andrew Georges, Pascal Grosu, Irina Kahn, David Lois, Fernande Momeni, Mona Pospiech, Audrey Yemnga, Bernadette Bosinceanu, Dana Collard, Edith European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology. Forget, Patrice Mortality after surgery in Europe: a 7 day cohort study |
topic_facet |
Adult Length of Stay Male Middle Aged Postoperative Care Surgical Procedures Operative Treatment Outcome Aged Cohort Studies Critical Care Europe Female Hospital Mortality Hospitalization Humans |
description |
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 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. 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 ... |
author2 |
UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire UCL - SSS/IREC/MEDA - Pôle de médecine aiguë UCL - SSS/IONS/NEUR - Clinical Neuroscience UCL - (SLuc) Service d'anesthésiologie |
format |
Article in Journal/Newspaper |
author |
Pearse, Rupert M Moreno, Rui P Bauer, Peter Pelosi, Paolo Metnitz, Philipp Spies, Claudia Vallet, Benoit Vincent, Jean-Louis De Kock, Marc Hoeft, Andreas Rhodes, Andrew Georges, Pascal Grosu, Irina Kahn, David Lois, Fernande Momeni, Mona Pospiech, Audrey Yemnga, Bernadette Bosinceanu, Dana Collard, Edith European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology. Forget, Patrice |
author_facet |
Pearse, Rupert M Moreno, Rui P Bauer, Peter Pelosi, Paolo Metnitz, Philipp Spies, Claudia Vallet, Benoit Vincent, Jean-Louis De Kock, Marc Hoeft, Andreas Rhodes, Andrew Georges, Pascal Grosu, Irina Kahn, David Lois, Fernande Momeni, Mona Pospiech, Audrey Yemnga, Bernadette Bosinceanu, Dana Collard, Edith European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology. Forget, Patrice |
author_sort |
Pearse, Rupert M |
title |
Mortality after surgery in Europe: a 7 day cohort study |
title_short |
Mortality after surgery in Europe: a 7 day cohort study |
title_full |
Mortality after surgery in Europe: a 7 day cohort study |
title_fullStr |
Mortality after surgery in Europe: a 7 day cohort study |
title_full_unstemmed |
Mortality after surgery in Europe: a 7 day cohort study |
title_sort |
mortality after surgery in europe: a 7 day cohort study |
publisher |
TheLancet Publishing Group |
publishDate |
2012 |
url |
http://hdl.handle.net/2078.1/118521 https://doi.org/10.1016/S0140-6736(12)61148-9 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
The Lancet, Vol. 380, no. 9847, p. 1059-1065 (2012) |
op_relation |
boreal:118521 http://hdl.handle.net/2078.1/118521 doi:10.1016/S0140-6736(12)61148-9 info:pmid/22998715 urn:ISSN:0140-6736 urn:EISSN:1474-547X |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1016/S0140-6736(12)61148-9 |
container_title |
The Lancet |
container_volume |
380 |
container_issue |
9847 |
container_start_page |
1059 |
op_container_end_page |
1065 |
_version_ |
1799482753327038464 |