Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study
Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study
Background: the outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes.
Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January-December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien-Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141).
Results: a total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively.
Conclusions: this is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives.
Humans, Cross-Sectional Studies, Prospective Studies, Liver, Elective Surgical Procedures/adverse effects, Hospitals
3954-3966
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
LiverGroup.org Collaborative*
1 December 2023
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
LiverGroup.org Collaborative*
(2023)
Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study.
International journal of surgery (London, England), 109 (12), .
(doi:10.1097/JS9.0000000000000711).
Abstract
Background: the outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes.
Methods: LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January-December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien-Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141).
Results: a total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively.
Conclusions: this is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives.
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Accepted/In Press date: 14 August 2023
Published date: 1 December 2023
Additional Information:
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Keywords:
Humans, Cross-Sectional Studies, Prospective Studies, Liver, Elective Surgical Procedures/adverse effects, Hospitals
Identifiers
Local EPrints ID: 487450
URI: http://eprints.soton.ac.uk/id/eprint/487450
ISSN: 1743-9159
PURE UUID: 06bb456b-a289-4529-9a88-5f37fa85295a
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Date deposited: 20 Feb 2024 18:09
Last modified: 18 Mar 2024 02:40
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Corporate Author: LiverGroup.org Collaborative*
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