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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis
British Journal of Anaesthesia, Volume 120, No. 1, Year 2018
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Description
Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P<0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P<0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P<0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine. © 2017 British Journal of Anaesthesia
Authors & Co-Authors
Abbott, Tom Ef
United Kingdom, London
Queen Mary University of London
Ahmad, Tahania
United Kingdom, London
Queen Mary University of London
Phull, Mandeep Kaur
United Kingdom, London
Barts Health Nhs Trust
Fowler, Alexander James
United Kingdom, London
Guy's and st Thomas' Nhs Foundation Trust
Hewson, Russell W.
United Kingdom, London
Barts Health Nhs Trust
Biccard, Bruce Mclure
South Africa, Cape Town
Faculty of Health Sciences
Chew, Michelle S.
Sweden, Linkoping
Linköpings Universitet
Gillies, Michael A.
United Kingdom, Edinburgh
The University of Edinburgh
Pearse, Rupert M.
United Kingdom, London
Queen Mary University of London
Beattie, William Scott
Unknown Affiliation
Clavien, Pierre Alain
Unknown Affiliation
Demartines, Nicolas
Unknown Affiliation
Fleisher, Lee A.
Unknown Affiliation
Grocott, Michael P.W.
Unknown Affiliation
Haddow, James Boyd
Unknown Affiliation
Hoeft, Andreas
Unknown Affiliation
Holt, Peter J.E.
Unknown Affiliation
Moreno, Rui Paulo
Unknown Affiliation
Pritchard, Naomi
Unknown Affiliation
Rhodes, Andrew
Unknown Affiliation
Wijeysundera, Duminda N.
Unknown Affiliation
Wilson, Matt G.
Unknown Affiliation
Ahmed, Tahania
Unknown Affiliation
Everingham, Kirsty
Unknown Affiliation
Januszewska, Marta
Unknown Affiliation
Halliwell, Richard M.T.
Unknown Affiliation
Shulman, Mark A.
Unknown Affiliation
Myles, Paul S.
Unknown Affiliation
Schmid, Werner
Unknown Affiliation
Hiesmayr, Michael J.
Unknown Affiliation
Wouters, Patrick F.
Unknown Affiliation
de Hert, Stefan G.
Unknown Affiliation
Lobo, Suzana Margareth Ajeje
Unknown Affiliation
Fang, Xiangming
Unknown Affiliation
Rasmussen, Lars Simon
Unknown Affiliation
Futier, Emmanuel
Unknown Affiliation
Biais, Matthieu
Unknown Affiliation
Vénara, Aurélien
Unknown Affiliation
Slim, Karem
Unknown Affiliation
Sander, Michael
Unknown Affiliation
Koulenti, Despoina
Unknown Affiliation
Arvaniti, Kostoula
Unknown Affiliation
Chan, Matthew Tak Vai
Unknown Affiliation
Kulkarni, Atul Prabhakar
Unknown Affiliation
Chandra, Susilo
Unknown Affiliation
Tantri, Aida Rosita
Unknown Affiliation
Geddoa, Emad
Unknown Affiliation
Abbas, Muntadhar
Unknown Affiliation
Della-Rocca, Giorgio
Unknown Affiliation
Sivasakthi, Datin
Unknown Affiliation
Mansor, Marzida Binti
Unknown Affiliation
Luna, Pastor
Unknown Affiliation
Bouwman, R. Arthur
Unknown Affiliation
Buhre, Wolfgang F.F.A.
Unknown Affiliation
Beavis, Vanessa S.
Unknown Affiliation
Campbell, Doug
Unknown Affiliation
Short, Timothy G.
Unknown Affiliation
Osinaike, Tunde
Unknown Affiliation
Matos, Ricardo
Unknown Affiliation
Grigoras, Ioana
Unknown Affiliation
Kirov, M. Yu
Unknown Affiliation
Protsenko, Denis N.
Unknown Affiliation
Aldecoa Álvarez-Santuyano, César
Unknown Affiliation
Hofer, Christoph Karl
Unknown Affiliation
Hübner, Martin
Unknown Affiliation
Ditai, James
Unknown Affiliation
Szakmany, Tamas
Unknown Affiliation
Fleisher, Lee A.
Unknown Affiliation
Ferguson, Marissa T.
Unknown Affiliation
MacMahon, Michael
Unknown Affiliation
Cherian, Ritchie
Unknown Affiliation
Currow, Helen
Unknown Affiliation
Kanathiban, Kathirgamanathan
Unknown Affiliation
Gillespie, David
Unknown Affiliation
Pathmanathan, Edward
Unknown Affiliation
Phillips, Katherine
Unknown Affiliation
Reynolds, Jenifer R.
Unknown Affiliation
Rowley, Joanne
Unknown Affiliation
Douglas, Jeanene Lizbeth
Unknown Affiliation
Kerridge, Ross K.
Unknown Affiliation
Garg, Sameer
Unknown Affiliation
Bennett, Michael H.
Unknown Affiliation
Jain, Megha
Unknown Affiliation
Alcock, David
Unknown Affiliation
Terblanche, Nico C.S.
Unknown Affiliation
Cotter, Rochelle
Unknown Affiliation
Leslie, Kate E.
Unknown Affiliation
Stewart, Marcelle
Unknown Affiliation
Zingerle, Nicolette
Unknown Affiliation
Clyde, Antony
Unknown Affiliation
Hambidge, Oliver R.H.
Unknown Affiliation
Rehak, Adam
Unknown Affiliation
Cotterell, Sharon
Unknown Affiliation
Huynh, Wilson Binh Quan
Unknown Affiliation
McCulloch, Timothy James
Unknown Affiliation
Ben-Menachem, Erez
Unknown Affiliation
Egan, Thomas
Unknown Affiliation
Cope, Jennifer
Unknown Affiliation
Fellinger, Paul
Unknown Affiliation
Haselberger, Simone
Unknown Affiliation
Holaubek, Caroline
Unknown Affiliation
Lichtenegger, Paul
Unknown Affiliation
Scherz, Florian
Unknown Affiliation
Klug, Reinhold
Unknown Affiliation
Buerkle, Christian
Unknown Affiliation
Forget, Patrice
Unknown Affiliation
Kahn, David A.
Unknown Affiliation
Lois, Fernande Jane
Unknown Affiliation
Momeni, Mona
Unknown Affiliation
Pospiech, Audrey L.
Unknown Affiliation
Steyaert, Arnaud
Unknown Affiliation
Poelaert, Jan I.T.
Unknown Affiliation
Bouchez, Stefaan M.
Unknown Affiliation
Heyse, Björn E.K.
Unknown Affiliation
Jacobs, Tom Frans
Unknown Affiliation
Roels, Nathalie R.A.
Unknown Affiliation
Limmen, Jurgen Van
Unknown Affiliation
Vanpeteghem, Caroline M.
Unknown Affiliation
Wyffels, Piet A.H.
Unknown Affiliation
Dylst, Dimitri
Unknown Affiliation
Junior, Paulo do Nascimento
Unknown Affiliation
Caser, Eliana Bernadete
Unknown Affiliation
Piras, Cláudio
Unknown Affiliation
Funk, Duane J.
Unknown Affiliation
George, Ronald B.
Unknown Affiliation
Jones, Philip M.G.
Unknown Affiliation
Hall, Richard I.
Unknown Affiliation
Hare, Gregory M.T.
Unknown Affiliation
Choi, Stephen Deanne
Unknown Affiliation
McCartney, Colin J.L.
Unknown Affiliation
Carroll, Jo Ann
Unknown Affiliation
Perlas, Anahi
Unknown Affiliation
Yuan, Fang
Unknown Affiliation
Rasmussen, Bodil Steen
Unknown Affiliation
Larsen, Michael Hareskov
Unknown Affiliation
Belœil, Hélène
Unknown Affiliation
Lasocki, Sigismond
Unknown Affiliation
Legouge, Marie Lim
Unknown Affiliation
Tesnier̀e, Antoine
Unknown Affiliation
Mutter, Didier
Unknown Affiliation
Ouaïssi, Mehdi
Unknown Affiliation
Régimbeau, Jean Marc
Unknown Affiliation
Lebuffe, Gilles R.
Unknown Affiliation
Wittmann, Maria
Unknown Affiliation
Goebel, Ulrich
Unknown Affiliation
Harris, Sarah E.
Unknown Affiliation
Gkiokas, Georgios A.
Unknown Affiliation
Georgiou, Georgios K.
Unknown Affiliation
Tsigou, Evdoxia
Unknown Affiliation
Mainas, Efstratios
Unknown Affiliation
Ioannidis, Orestis M.
Unknown Affiliation
Stamatiou, Konstantinos
Unknown Affiliation
Andreou, Alexandros G.
Unknown Affiliation
Koulouras, Vasilios P.
Unknown Affiliation
Papadopoulos, Dimitrios B.
Unknown Affiliation
Stamoulis, Konstantinos G.
Unknown Affiliation
Koo, Emily Gar Yee
Unknown Affiliation
Shah, Bhagyesh Ashwinkumar
Unknown Affiliation
Divatia, Jigeeshu Vasishtha
Unknown Affiliation
Mishra, Sanghamitra S.
Unknown Affiliation
Spadaro, S.
Unknown Affiliation
Roasio, Agostino
Unknown Affiliation
Bignami, Elena Giovanna
Unknown Affiliation
Cabrini, Luca
Unknown Affiliation
Landoni, Giovanni
Unknown Affiliation
Winterton, Dario
Unknown Affiliation
Zangrillo, Alberto
Unknown Affiliation
Gastaldi, Christian
Unknown Affiliation
Pata, Francesco
Unknown Affiliation
Joseph, James
Unknown Affiliation
Statistics
Citations: 95
Authors: 170
Affiliations: 6
Identifiers
Doi:
10.1016/j.bja.2017.08.002
ISSN:
00070912
Research Areas
Health System And Policy
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative
Systematic review