Anaemia affects nearly a quarter of the world's population and is common in surgical patients [1]. A third of patients are anaemic before surgery and three-quarters of patients are discharged from hospital with anaemia [2]. The World Health Organization defines anaemia as an insufficient circulating red cell mass, with a haemoglobin concentration of <130 g/l for men and <120 g/l for women [1].Perioperative anaemia is associated with delayed patient recovery and increased postoperative complications, leading to increased postoperative morbidity and mortality [1][2][3][4][5][6][7]. It also leads to an increased use of allogeneic blood transfusions [7-10], which is an independent risk factor for poorer patient outcome [10][11][12][13].Postoperative anaemia is multifactorial, associated with operative blood loss and phlebotomy, and is also secondary to the inflammatory process associated with surgery, which has a negative impact
Background Cholecystectomy is a commonly performed procedure; however, it is not without risks. It is crucial to constantly audit surgical outcomes in order to improve quality of care. The aim of this retrospective population-based cohort study is to identify preventable issues of clinical management associated with adverse occurrences in order to reduce mortality of cholecystectomy patients. Methods Data were obtained from the Australian and New Zealand Audit of Surgical Mortality (ANZASM). It encompasses peer-reviewed first and second line assessments of management of cholecystectomy patients who died from 2005 to 2015 in Australia. Clinical Management Issues (CMIs) were identified from text in assessments and grouped into communication failures, pre-operative, intra-operative and post-operative categories. These were further classified into subthemes using thematic analysis with a data-driven approach. Results There were 359 deaths in the study period. CMIs were present in 71 cases, with a reported total of 124 concerns or adverse events. Post-operative CMIs were the most prevalent issue [50% (62/124)], with the most common theme being delay to recognise complications (19/124). Pre-operative concerns were the second most common (n = 34). Decision to operate was questioned in 14 cases, and delay to surgery was reported in 12 cases. Conclusion ANZASM analysis has allowed us to identify modifiable adverse occurrences. This audit shows that delay to recognise complications is the most common assessment recorded. Preventive measures should be taken to improve outcomes and reduce peri-operative mortality, with an emphasis on post-operative management and enhancing communication between members of the multidisciplinary team.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.