Malago, Massimo;
Serrablo, Alejandro;
Raptis, Dimitri Aristotle;
Dervenis, Christos;
Oldhafer, Karl Jurgen;
Machado, Marcel Autran;
Kokudo, Norihiro;
... Andreoli, Gustavo; + view all
(2023)
Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study.
International Journal of Surgery
, 109
(12)
pp. 3954-3966.
10.1097/JS9.0000000000000711.
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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.
| Type: | Article |
|---|---|
| Title: | Outcomes of elective liver surgery worldwide: a global, prospective, multicenter, cross-sectional study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/JS9.0000000000000711 |
| Publisher version: | http://dx.doi.org/10.1097/js9.0000000000000711 |
| Language: | English |
| Additional information: | Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Surgery, failure to rescue, global surgery, human development index, liver surgery, morbidity, mortality, outcomes, RESECTION, HEPATECTOMY, FAILURE, RESCUE, BENIGN, COHORT, HEALTH, IMPACT, INDEX |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10192326 |
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