Surgical mortality – An analysis of all deaths within a general surgical department

Heeney, Anna; Hand, Fiona; Bates, James E.; Cormack, Orla Mc; Mealy, K.

doi:10.1016/j.surge.2013.07.005

Cited by 26 publications

(27 citation statements)

References 14 publications

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“…SSI and seroma formation occur infrequently. Moreover, severe complications were rarely reported and 30-day mortality rates did not exceed risks which are generally associated with surgical procedures under general anaesthesia 114,115 …”

Section: Discussionmentioning

confidence: 99%

Favorable Outcomes After Retro-Rectus (Rives-Stoppa) Mesh Repair as Treatment for Noncomplex Ventral Abdominal Wall Hernia, a Systematic Review and Meta-analysis

et al. 2022

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Objective: To assess prevalence of hernia recurrence, surgical site infection (SSI), seroma, serious complications, and mortality after retro-rectus repair. Summary Background Data: Ventral abdominal wall hernia is a common problem, tied to increasing frailty and obesity of patients undergoing surgery. For noncomplex ventral hernia, retro-rectus (Rives-Stoppa) repair is considered the gold standard treatment. Level-1 evidence confirming this presumed superiority is lacking. Methods: Five databases were searched for studies reporting on retro-rectus repair. Single-armed and comparative randomized and non-randomized studies were included. Outcomes were pooled with mixed-effects, inverse variance or random-effects models. Results: Ninety-three studies representing 12,440 patients undergoing retrorectus repair were included. Pooled hernia recurrence was estimated at 3.2% [95% confidence interval (CI): 2.2%-4.2%, n ¼ 11,049] after minimally 12months and 4.1%, (95%CI: 2.9%-5.5%, n ¼ 3830) after minimally 24 months. Incidences of SSI and seroma were estimated at respectively 5.2% (95%CI: 4.2%-6.4%, n ¼ 4891) and 5.5% (95%CI: 4.4%-6.8%, n ¼ 3650). Retro-rectus repair was associated with lower recurrence rates compared to onlay repair [odds ratios (OR): 0.27, 95%CI: 0.15-0.51, P < 0.001] and equal recurrence rates compared to intraperitoneal onlay mesh (IPOM) repair (OR: 0.92, 95%CI: 0.75-1.12, P ¼ 0.400). Retro-rectus repair was associated with more SSI than IPOM repair (OR: 1.8, 95%CI: 1.03 -3.14, P ¼ 0.038). Minimally invasive retro-rectus repair displayed low rates of recurrence (1.3%, 95%CI: 0.7%-2.3%, n ¼ 849) and SSI (1.5%, 95%CI: 0.8%-2.8%, n ¼ 982), albeit based on non-randomized studies.Conclusions: Retro-rectus (Rives-Stoppa) repair results in excellent outcomes, superior or similar to other techniques for all outcomes except SSI. The latter rarely occurred, yet less frequently after IPOM repair, which is usually performed by laparoscopy.

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Section: Discussionmentioning

confidence: 99%

Favorable Outcomes After Retro-Rectus (Rives-Stoppa) Mesh Repair as Treatment for Noncomplex Ventral Abdominal Wall Hernia, a Systematic Review and Meta-analysis

et al. 2022

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“…This study does not appear deaths; due to the differences of the case range, the results do not tally with the study of Heeney et al . [ 31 ] But the results still hint that according to the blood transfusion scheme guided by POTTS-E, complications and death risk are not increased, and there are no significant differences in the postoperative vital signs, suggesting the safety of POTTS-E scheme. But limited by the number of cases and the research time, this study fails to complete the comparison in the postoperative quality of life and longer follow-up.…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Study on Safety and Feasibility of Transfusion Trigger Score of Emergency Operations

Liu

Zhang

et al. 2015

Chinese Medical Journal

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Background:Due to the floating of the guideline, there is no evidence-based evaluation index on when to start the blood transfusion for patients with hemoglobin (Hb) level between 7 and 10 g/dl. As a result, the trigger point of blood transfusion may be different in the emergency use of the existing transfusion guidelines. The present study was designed to evaluate whether the scheme can be safely and effectively used for emergency patients, so as to be supported by multicenter and large sample data in the future.Methods:From June 2013 to June 2014, patients were randomly divided into the experimental group (Peri-operative Transfusion Trigger Score of Emergency [POTTS-E] group) and the control group (control group). The between-group differences in the patients’ demography and baseline information, mortality and blood transfusion-related complications, heart rate, resting arterial pressure, body temperature, and Hb values were compared. The consistency of red blood cell (RBC) transfusion standards of the two groups of patients with the current blood transfusion guideline, namely the compliance of the guidelines, utilization rate, and per-capita consumption of autologous RBC were analyzed.Results:During the study period, a total of 72 patients were recorded, and 65 of them met the inclusion criteria, which included 33 males and 32 females with a mean age of (34.8 ± 14.6) years. 50 underwent abdomen surgery, 4 underwent chest surgery, 11 underwent arms and legs surgery. There was no statistical difference between the two groups for demography and baseline information. There was also no statistical differences between the two groups in anesthesia time, intraoperative rehydration, staying time in postanesthetic care unit, emergency hospitalization, postoperative 72 h Acute Physiologic Assessment and Chronic Health Evaluation II scores, blood transfusion-related complications and mortality. Only the POTTS-E group on the 1st postoperative day Hb was lower than group control, P < 0.05. POTTS-E group was totally (100%) conformed to the requirements of the transfusion guideline to RBC infusion, which was higher than that of the control group (81.25%), P < 0.01. There were no statistical differences in utilization rates of autologous blood of the two groups; the utilization rates of allogeneic RBC, total allogeneic RBC and total RBC were 48.48%, 51.5%, and 75.7% in POTTS-E group, which were lower than those of the control group (84.3%, 84.3%, and 96.8%) P < 0.05 or P < 0.01. Per capita consumption of intraoperative allogeneic RBC, total allogeneic RBC and total RBC were 0 (0, 3.0), 2.0 (0, 4.0), and 3.1 (0.81, 6.0) in POTTS-E groups were all lower than those of control group (4.0 [2.0, 4.0], 4.0 [2.0, 6.0] and 5.8 [2.7, 8.2]), P < 0.05 or P < 0.001.Conclusions:Peri-operative Transfusion Trigger Score-E evaluation scheme is used to guide the application of RBC. There are no differences in the recent prognosis of patients with the traditional transfusion guidelines. This scheme is safe; Compared with doctor experience-based ...

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“…It is widely accepted that patients who require urgent surgery for intestinal conditions tend to have worse outcomes when compared with those who undergo elective procedures . However, divergent results in regard to the 30 days mortality rates for these patients have been reported.…”

Section: Introductionmentioning

confidence: 99%

Outcomes in patients undergoing urgent colorectal surgery

Teloken

Spilsbury

Levitt

et al. 2014

ANZ Journal of Surgery

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Surgical mortality – An analysis of all deaths within a general surgical department

Cited by 26 publications

References 14 publications

Favorable Outcomes After Retro-Rectus (Rives-Stoppa) Mesh Repair as Treatment for Noncomplex Ventral Abdominal Wall Hernia, a Systematic Review and Meta-analysis

Favorable Outcomes After Retro-Rectus (Rives-Stoppa) Mesh Repair as Treatment for Noncomplex Ventral Abdominal Wall Hernia, a Systematic Review and Meta-analysis

Randomized Controlled Study on Safety and Feasibility of Transfusion Trigger Score of Emergency Operations

Outcomes in patients undergoing urgent colorectal surgery

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