The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis
Publication in refereed journal

香港中文大學研究人員

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其它資訊
摘要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.
出版社接受日期18.09.2017
著者T.E.F. Abbott, T. Ahmad, M.K. Phull, A.J. Fowler, R. Hewson, B.M. Biccard, M.S. Chew, M. Gilliesan, R.M. Pearse, for the International Surgical Outcomes Study (ISOS) group
期刊名稱British Journal of Anaesthesia
出版年份2018
月份1
卷號120
期次1
頁次146 - 155
國際標準期刊號0007-0912
電子國際標準期刊號1471-6771
語言英式英語
關鍵詞cohort studies, operative/mortality, postoperative care/methods, postoperative care/statistics and numerical data, surgery, surgical procedures

上次更新時間 2021-22-02 於 01:14