ReviewFrontiers in surgery2015
Addressing the Global Burden of Trauma in Major Surgery.
Review in Frontiers in surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 127 citations in OpenAlex.
- Improvement of inflammatory response and gastrointestinal function in perioperative of cholelithiasis by Modified Xiao-Cheng-Qi decoction.World journal of clinical cases · 2023Trial
- Prognosis comparison and prognostic model construction in patients with Siewert type II adenocarcinoma of the esophagogastric junction after neoadjuvant therapy between proximal gastrectomy and total gastrectomy.Journal of thoracic disease · 2026Article
- Impact of Preoperative Functional Capacity on Postoperative Mortality and Morbidity: A Prospective Cohort Study.Anesthesiology · 2026Article
- Feeding tube dependence and postoperative complications in older adults after head and neck cancer surgery: a retrospective cohort study.BMC geriatrics · 2026Article
- Association of Psychiatric Disorder Comorbidities With Global and Orbital Ablative Surgeries: A Real-World Retrospective Cohort Study.Psychiatry investigation · 2026Article
- Age-related variation in the association between intraoperative dynamic cerebral autoregulation impairment proportion and postoperative neutrophil-to-lymphocyte ratio: an exploratory observational study.Frontiers in aging neuroscience · 2026Article
- Robot-Assisted Colorectal Cancer Surgery Mitigates Early Postoperative Immunosuppression and Angiogenesis.International journal of molecular sciences · 2025Article
- Gender Equity Issues in Orthopaedics: A Scoping Review.Indian journal of orthopaedics · 2025Review
- Effect of a Laparoscopic Donor Nephrectomy in Healthy Living Kidney Donors on the Acute Phase Response Using Either Propofol or Sevoflurane Anesthesia.International journal of molecular sciences · 2025Article
- Multimodal Prehabilitation in Major Abdominal Surgery-Rationale, Modalities, Results and Limitations.Medicina (Kaunas, Lithuania) · 2025Review
- Trauma systems: a global comparison.OTA international : the open access journal of orthopaedic trauma · 2025Article
- Amino Acid Supplementation May Help Prevent Muscle Wasting After Orthopedic Surgery, but Additional Studies Are Warranted: A Systematic Review of Randomized Clinical Trials.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2025Review
- Impact of perioperative organ injury on morbidity and mortality in 28 million surgical patients.Nature communications · 2025Article
- Assessment of laparotomy-induced stress response in opium- and morphine-addicted rats by measuring serum glucose and corticosterone levels: an animal experiment.Annals of medicine and surgery (2012) · 2025Article
- Major Adverse Cardiovascular Events After Colorectal Cancer Surgery, Oncological Outcomes, and Long-term Mortality: A Nationwide Retrospective Propensity Score-Matched Cohort Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Trauma by the Numbers: A Cross-Sectional Analysis and Categorization of Trauma Cases in the Gaza War.International journal of public health · 2025Article
- Associations between intraoperative nociceptive response index and early postoperative acute kidney injury in patients undergoing non-cardiac surgery under general anesthesia: a single-center retrospective cohort study.Journal of clinical monitoring and computing · 2024Article
- Association of postoperative opioid type with mortality and readmission rates: multicentre retrospective cohort study.BJS open · 2024Article
- Applying enhanced recovery principles to emergency laparotomy in penetrating abdominal trauma: a case-matched study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Revolution in sepsis: a symptoms-based to a systems-based approach?Journal of biomedical science · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite a technically perfect procedure, surgical stress can determine the success or failure of an operation. Surgical trauma is often referred to as the "neglected step-child" of global health in terms of patient numbers, mortality, morbidity, and costs. A staggering 234 million major surgeries are performed every year, and depending upon country and institution, up to 4% of patients will die before leaving hospital, up to 15% will have serious post-operative morbidity, and 5-15% will be readmitted within 30 days. These percentages equate to around 1000 deaths and 4000 major complications every hour, and it has been estimated that 50% may be preventable. New frontline drugs are urgently required to make major surgery safer for the patient and more predictable for the surgeon. We review the basic physiology of the stress response from neuroendocrine to genomic systems, and discuss the paucity of clinical data supporting the use of statins, beta-adrenergic blockers and calcium-channel blockers. Since cardiac-related complications are the most common, particularly in the elderly, a key strategy would be to improve ventricular-arterial coupling to safeguard the endothelium and maintain tissue oxygenation. Reduced O2 supply is associated with glycocalyx shedding, decreased endothelial barrier function, fluid leakage, inflammation, and coagulopathy. A healthy endothelium may prevent these "secondary hit" complications, including possibly immunosuppression. Thus, the four pillars of whole body resynchronization during surgical trauma, and targets for new therapies, are: (1) the CNS, (2) the heart, (3) arterial supply and venous return functions, and (4) the endothelium. This is termed the Central-Cardio-Vascular-Endothelium (CCVE) coupling hypothesis. Since similar sterile injury cascades exist in critical illness, accidental trauma, hemorrhage, cardiac arrest, infection and burns, new drugs that improve CCVE coupling may find wide utility in civilian and military medicine.
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