000165433 001__ 165433
000165433 005__ 20260108143204.0
000165433 0247_ $$2doi$$a10.1016/S0140-6736(12)61148-9
000165433 0248_ $$2sideral$$a118423
000165433 037__ $$aART-2012-118423
000165433 041__ $$aeng
000165433 100__ $$aPearse, Rupert M.
000165433 245__ $$aMortality after surgery in Europe: a 7 day cohort study
000165433 260__ $$c2012
000165433 5060_ $$aAccess copy available to the general public$$fUnrestricted
000165433 5203_ $$aBackground
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 χ2 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 care for this group of patients.
000165433 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000165433 590__ $$a39.06$$b2012
000165433 591__ $$aMEDICINE, GENERAL & INTERNAL$$b2 / 153 = 0.013$$c2012$$dQ1$$eT1
000165433 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000165433 700__ $$aMoreno, Rui P.
000165433 700__ $$aBauer, Peter
000165433 700__ $$aPelosi, Paolo
000165433 700__ $$aMetnitz, Philipp
000165433 700__ $$aSpies, Claudia
000165433 700__ $$aBenoit Vallet, Benoit
000165433 700__ $$aVincent, Jean-Louis
000165433 700__ $$aHoeft, Andreas
000165433 700__ $$aRhodes, Andrew
000165433 700__ $$0(orcid)0000-0002-8068-5016$$aSerón Arbeloa, Carlos$$uUniversidad de Zaragoza
000165433 700__ $$afor the European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology*
000165433 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000165433 773__ $$g380, 9847 (2012), 1059-65$$pLancet$$tThe Lancet$$x0140-6736
000165433 8564_ $$s286402$$uhttps://zaguan.unizar.es/record/165433/files/texto_completo.pdf$$yVersión publicada
000165433 8564_ $$s3251492$$uhttps://zaguan.unizar.es/record/165433/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000165433 909CO $$ooai:zaguan.unizar.es:165433$$particulos$$pdriver
000165433 951__ $$a2026-01-08-14:10:32
000165433 980__ $$aARTICLE