Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy. BJS 2019; 106: e103-e112.
Published: 8th January 2019
Authors: Hannah S Thomas, Thomas G Weiser, Thomas M Drake, Stephen R Knight, Cameron Fairfield, Adesoji O Ademuyiwa et al.
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.
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.
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.
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.Full text
You may also be interested in
Validation of the Norwegian survival prediction model in trauma (NORMIT) in Swedish trauma populations.
Authors: P. Ghorbani, T. Troëng, O. Brattström, K. G. Ringdal, T. Eken, A. Ekbom et al.
Authors: E. H. Wright, M. Tyler, B. Vojnovic, J. Pleat, A. Harris, D. Furniss et al.
Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons’ national registry.
Authors: N. Patel, R. J. Egan, B. R. Carter, D. M. Scott‐Coombes, M. J. Stechman, A. Afzaal et al.
Authors: M. Di Paolo, U. Boggi, E. Turillazzi
Authors: S. J. Chapman, M. Aldaffaa, C. L. Downey, D. G. Jayne
Authors: D. Campbell, L. Boyle, M. Soakell‐Ho, P. Hider, L. Wilson, J. Koea et al.
Authors: S. L. Lee, A. Al‐Shamkhani, A. Mirnezami
External validation of a prognostic model to predict survival of patients with sentinel node‐negative melanoma. BJS 2019; 106: 1319-1326.
Authors: N. A. Ipenburg, O. E. Nieweg, T. Ahmed, R. van Doorn, R. A. Scolyer, G. V. Long et al.
Meta‐analysis of randomized clinical trials of early versus delayed cholecystectomy for mild gallstone pancreatitis.
Authors: N. Moody, A. Adiamah, F. Yanni, D. Gomez
Meta‐analysis of the role of colonoscopy after an episode of left‐sided acute diverticulitis. BJS 2019; 106: 988-997.
Authors: S. J. Rottier, S. T. Dijk, A. A. W. Geloven, W. H. Schreurs, W. A. Draaisma, W. A. Enst et al.