Key result
Surgical safety checklists are linked to ~14% lower postoperative morbidity in GI tumor patients.
Why the study?
The WHO surgical safety checklist reduces postoperative complications, but its impacts after implementation in China had not been evaluated clearly.
Does the implementation of the WHO surgical safety checklist reduce postoperative complications in patients undergoing elective surgery for gastrointestinal tumors?
Cohort (n=7,209)
No
Does the implementation of the WHO surgical safety checklist reduce postoperative complications in patients undergoing elective surgery for gastrointestinal tumors?
Effect estimate: OR 0.860 (95% CI 0.750-0.988)
Absolute Event Rate: 14.33% vs 16.43%
p-value: p=0.018
Implementation of the WHO surgical safety checklist significantly reduced postoperative complications and in-hospital mortality in patients undergoing elective gastrointestinal tumor surgery.
Supports checklist use in GI tumor surgery; extends prior data but leaves causality open pending RCTs.
A 19-item surgical safety checklist (SSC) was published by the World Health Organization in 2008 and was proved to reduce postoperative complications. To date, however, the impacts of SSC implementation in China have not been evaluated clearly. The study was performed to evaluate the impacts of the SSC on postoperative clinical outcomes in gastrointestinal tumor patients.Between April 2007 and March 2013, 7209 patients with gastrointestinal tumor who underwent elective surgery at the Affiliated Hospital of Qingdao University were studied. Data on the clinical records and outcomes of 3238 consecutive surgeries prior to SSC implementation were retrospectively collected; data on another 3971 consecutive surgeries performed after SSC implementation were prospectively collected. The clinical outcomes (including mortality, morbidity, readmission, reoperation, unplanned intervention and postoperative hospital stay) within postoperative 30 days were compared between the two groups. Univariate and multivariate logistic regression analysis were performed to identify independent factors for postoperative complications.The rates of morbidity and in-hospital mortality before and after SSC implementation were 16.43% vs 14.33% (P = .018), 0.46% vs 0.18% (P = .028), respectively. Median of postoperative hospital stay in post-implementation group was shorter than that in pre-implementation group (8 vs 9 days, P < .001). Multivariable analysis demonstrated that the SSC was an independent factor influencing postoperative complications (odds ratio = 0.860; 95% CI, 0.750-0.988).Implementation of the SSC could improve the clinical outcomes in gastrointestinal tumor patients undergoing elective surgery in China.
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Wang et al. (2019) conducted a cohort in Gastrointestinal tumors (n=7,209). Surgical safety checklist (SSC) vs. Pre-implementation (no checklist) was evaluated on Postoperative morbidity within 30 days (OR 0.860, 95% CI 0.750-0.988, p=0.018). Implementation of a 19-item surgical safety checklist reduced postoperative morbidity from 16.43% to 14.33% (OR 0.860) and in-hospital mortality from 0.46% to 0.18% in gastrointestinal tumor patients.
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