ArticleBMJ open2017
Cohort analysis of outcomes in 69 490 emergency general surgical admissions across an international benchmarking collaborative.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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.
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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.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Artificial Intelligence for Predicting Length of Stay for General Surgery Patients: A Systematic Review.World journal of surgery · 2026Pooled it
- Improving Quality of Carotid Interventions: Identifying Hospital-Level Structural Factors that can Improve Outcomes.Annals of vascular surgery · 2021Pooled it
- Surgeon-perceived intraoperative complexity is associated with early adverse outcomes after major emergency abdominal surgery: a prospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Postoperative pulmonary complications following major emergency abdominal surgery: incidence, risk factors, and outcomes-an observational study.Journal of anesthesia · 2026Article
- Outcomes of urgent gastrointestinal-related procedures in Latin America (LATAM-URG): a prospective multicentre study.Lancet regional health. Americas · 2026Article
- Intraoperative complexity markers are associated with morbidity but not mortality in emergency abdominal surgery: a two-year cohort study.Langenbeck's archives of surgery · 2026Article
- Safety and efficacy of prophylactic onlay resorbable synthetic mesh with a comprehensive wound bundle at laparotomy closure in high-risk emergency abdominal surgery: an observational study.World journal of emergency surgery : WJES · 2025Observational
- Identifying those at risk: predicting patient factors associated with worse EGS outcomes.Trauma surgery & acute care open · 2025Article
- Population-level trends in emergency general surgery presentations and mortality over time.The British journal of surgery · 2023Article
- Consensus Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERASWorld journal of surgery · 2023Review
- Enhanced Recovery After Surgery (ERAS®) Society Consensus Guidelines for Emergency Laparotomy Part 3: Organizational Aspects and General Considerations for Management of the Emergency Laparotomy Patient.World journal of surgery · 2023Review
- The impact of unplanned 30-day readmission as a quality indicator in pediatric surgery.Frontiers in surgery · 2023Article
- Development of the PIP score: A metric for predicting Intensive Care Unit admission among patients undergoing emergency laparotomy.Surgery in practice and science · 2022Article
- Article
- Major adverse cardiovascular events and all-cause mortality after emergency general surgery among kidney failure patients.BJS open · 2022Article
- Outcomes in patients requiring intensive care unit (ICU) admission after emergency laparotomy: A retrospective study.Acta anaesthesiologica Scandinavica · 2022Review
- Procedural Risks of Carotid Intervention in 19,000 Patients.Annals of vascular surgery · 2021Article
- Emergency laparotomy in the older patient: factors predictive of 12-month mortality-Salford-POPS-GS. An observational study.Aging clinical and experimental research · 2020Observational
- Volume and in-hospital mortality after emergency abdominal surgery: a national population-based study.BMJ open · 2019Article
- Predicting in-hospital mortality in older general surgical patients.Annals of the Royal College of Surgeons of England · 2018Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectiveThis study aims to use the Dr Foster Global Comparators Network (GC) database to examine differences in outcomes following high-risk emergency general surgery (EGS) admissions in participating centres across 3 countries and to determine whether hospital infrastructure factors can be linked to the delivery of high-quality care.
designA retrospective cohort analysis of high-risk EGS admissions using GC's international administrative data set.
setting23 large hospitals in Australia, England and the USA.
methodsDischarge data for a cohort of high-risk EGS patients were collated. Multilevel hierarchical logistic regression analysis was performed to examine geographical and structural differences between GC hospitals.
results69 490 patients, admitted to 23 centres across Australia, England and the USA from 2007 to 2012, were identified. For all patients within this cohort, outcomes defined as: 7-day and 30-day inhospital mortality, readmission and length of stay appeared to be superior in US centres. A subgroup of 19 082 patients (27%) underwent emergency abdominal surgery. No geographical differences in mortality were seen at 7 days in this subgroup. 30-day mortality (OR=1.47, p<0.01) readmission (OR=1.42, p<0.01) and length of stay (OR=1.98, p<0.01) were worse in English units. Patient factors (age, pathology, comorbidity) were significantly associated with worse outcome as were structural factors, including low intensive care unit bed ratios, high volume and interhospital transfers. Having dedicated EGS teams cleared of elective commitments with formalised handovers was associated with shorter length of stay.
conclusionsKey factors that influence outcomes were identified. For patients who underwent surgery, outcomes were similar at 7 days but not at 30 days. This may be attributable to better infrastructure and resource allocation towards EGS in the US and Australian centres.
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