Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy. Issue 2 (8th January 2019)

• Record Type: Journal Article
• Other Names: Thomas Hannah S investigator.; Weiser Thomas G investigator.; Drake Thomas M investigator.; Knight Stephen R investigator.; Fairfield Cameron investigator.; Ademuyiwa Adesoji O investigator.; Aguilera Maria Lorena investigator.; Alexander Philip investigator.; Alâ€�Saqqa Sara W investigator.; Bordaâ€�Luque Giuliano investigator.; Costasâ€�Chavarri Ainhoa investigator.; Ntirenganya Faustin investigator.; Fitzgerald J Edward investigator.; Fergusson Stuart J investigator.; Glasbey James investigator.; Ingabire J.C. Allen investigator.; Ismaïl Lawani investigator.; Salem Hosni Khairy investigator.; Kojo Anyomih Theophilus Teddy investigator.; Lapitan Marie Carmela investigator.; Lilford Richard investigator.; Mihaljevic Andre L investigator.; Morton Dion investigator.; Mutabazi Alphonse Zeta investigator.; Nepogodiev Dmitri investigator.; Adisa Adewale O investigator.; Ots Riinu investigator.; Pata Francesco investigator.; Pinkney Thomas investigator.; PoÅ¡kus Tomas investigator.; Qureshi Ahmad Uzair investigator.; la Medina Antonio Ramosâ€�De investigator.; Rayne Sarah investigator.; Shaw Catherine A investigator.; Shu Sebastian investigator.; Spence Richard investigator.; Smart Neil investigator.; Tabiri Stephen investigator.; Bhangu Aneel investigator.; Harrison Ewen M investigator.; Harrison Ewen M investigator.; Verjee Azmina investigator.; Runigamugabo Emmy investigator.; Ademuyiwa Adesoji O investigator.; Adisa Adewale O investigator.; Aguilera Maria Lorena investigator.; Altamini Afnan investigator.; Alexander Philip investigator.; Alâ€�Saqqa Sara W investigator.; Bordaâ€�Luque Giuliano investigator.; Cornick Jen investigator.; Costasâ€�Chavarri Ainhoa investigator.; Drake Thomas M investigator.; Fergusson Stuart J investigator.; Fitzgerald J Edward investigator.; Glasbey James investigator.; Ingabire J.C. Allen investigator.; Ismaïl Lawani investigator.; Jaffry Zahra investigator.; Salem Hosni Khairy investigator.; Khatri Chetan investigator.; Kirby Andrew investigator.; Kojo Anyomih Theophilus Teddy investigator.; Lapitan Marie Carmela investigator.; Lilford Richard investigator.; Mihaljevic Andre L investigator.; Mohan Midhun investigator.; Morton Dion investigator.; Mutabazi Alphonse Zeta investigator.; Nepogodiev Dmitri investigator.; Ntirenganya Faustin investigator.; Ots Riinu investigator.; Pata Francesco investigator.; Pinkney Thomas investigator.; PoÅ¡kus Tomas investigator.; Qureshi Ahmad Uzair investigator.; la Medina Antonio Ramosâ€�De investigator.; Rayne Sarah investigator.; Recinos Gustavo investigator.; Søreide Kjetil investigator.; Shaw Catherine A investigator.; Shu Sebastian investigator.; Spence Richard investigator.; Smart Neil investigator.; Tabiri Stephen investigator.; Harrison Ewen M investigator.; Bhangu Aneel investigator.; Khatri Chetan investigator.; Gobin Neel investigator.; Freitas Ana Vega investigator.; Hall Nigel investigator.; Kim Sungâ€�Hee investigator.; Negida Ahmed investigator.; Khairy Hosni investigator.; Jaffry Zahra investigator.; Chapman Stephen J investigator.; Arnaud Alexis P investigator.; Tabiri Stephen investigator.; Recinos Gustavo investigator.; Manipal Cutting Edge investigator.; Mohan Midhun investigator.; Amandito Radhian investigator.; Shawki Marwan investigator.; Hanrahan Michael investigator.; Pata Francesco investigator.; Zilinskas Justas investigator.; Roslani April Camilla investigator.; Goh Cheng Chun investigator.; Ademuyiwa Adesoji O investigator.; Irwin Gareth investigator.; Shu Sebastian investigator.; Luque Laura investigator.; Shiwani Hunain investigator.; Altamimi Afnan investigator.; Alsaggaf Mohammed Ubaid investigator.; Fergusson Stuart J investigator.; Spence Richard investigator.; Rayne Sarah investigator.; Jeyakumar Jenifa investigator.; Cengiz Yucel investigator.; Raptis Dmitri A investigator.; Glasbey James C investigator.; 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Farrugia Alexia investigator.; Borg Elaine investigator.; la Medina Antonio Ramosâ€�De investigator.; Bentounsi Zineb investigator.; Ademuyiwa Adesoji O investigator.; Søreide Kjetil investigator.; Gala Tanzeela investigator.; Alâ€�Slaibi Ibrahim investigator.; Tahboub Haya investigator.; Alser Osaid H. investigator.; Romani Diego investigator.; Shu Sebestian investigator.; Major Piotr investigator.; Mironescu Aurel investigator.; Bratu Matei investigator.; Kourdouli Amar investigator.; Ndajiwo Aliyu investigator.; Altwijri Abdulaziz investigator.; Alsaggaf Mohammed Ubaid investigator.; Gudal Ahmad investigator.; Jubran Al Faifi investigator.; Seisay Sam investigator.; Lieske Bettina investigator.; Rayne Sarah investigator.; Spence Richard investigator.; Ortega Irene investigator.; Jeyakumar Jenifa investigator.; Senanayake Kithsiri J. investigator.; Abdulbagi Omar investigator.; Cengiz Yucel investigator.; Raptis Dmitri investigator.; Altinel Yuksel investigator.; Kong Chia investigator.; 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• Is Part Of: British journal of surgery. Volume 106:Issue 2(2019)
• Page Start: e103
• Page End: e112
• Publication Date: 2019-01-08
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.11051
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract : Background: 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. Methods: 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. Results: 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 highâ€�HDI countries (risk difference âˆ'9·4 (95 per cent c.i. âˆ'11·9 to âˆ'6·9) per cent; P < 0·001), but the relationship was reversed in lowâ€�HDI countries (+12·1 (+7·0 to +17·3) per cent; P < 0·001). In multivariable models, checklist use was associated with a lower 30â€�day perioperative mortality (OR 0·60, 0·50 to 0·73; P < 0·001). The greatest absolute benefit was seen for emergency surgery in lowâ€� and middleâ€�HDI countries. Conclusion: Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in lowâ€�HDI countries was half that in highâ€�HDI countries. Abstract : WHO Surgical Safety checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality, yet its use in lowâ€�HDI countries was half that of highâ€�HDI countries. The greatest absolute gains may be made by focusing patient safety programmes in emergency settings in lowâ€� and middleâ€�HDI countries. Should be used in emergency laparotomy