Evidence map›Paper›PMID 29397122›Full record

SynthesisBritish journal of anaesthesia2018

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis.

T E F Abbott, T Ahmad, M K Phull, A J Fowler, R Hewson, B M Biccard, M S Chew, M Gillies, R M Pearse, International Surgical Outcomes Study (ISOS) group

Abstract readObservational StudySystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of anaesthesia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  7. Influence of a checklist -based management model on postoperative complication rates and hospitalization time after metabolic and bariatric surgery.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

T E F AbbottWilliam Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK.
T AhmadWilliam Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK.
M K PhullThe Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK.
A J FowlerGuys and St. Thomas's NHS Foundation Trust, London SE1 7EH, UK.
R HewsonThe Royal London Hospital, Barts Health NHS Trust, London E1 1BB, UK.
B M BiccardDepartment of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
M S ChewDepartment of Anaesthesia and Intensive Care, Faculty of Medicine and Health Sciences, Linköping University, 58185 Linköping, Sweden.
M GilliesDepartment of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh EH48 3DF, UK.
R M PearseWilliam Harvey Research Institute, Queen Mary University of London, London EC1M 6BQ, UK. Electronic address: r.pearse@qmul.ac.uk.
International Surgical Outcomes Study (ISOS) group

Funding

Clinical and Laboratory Research Training for Surgical OncologistsT32CA126607 · NCI · JOHNS HOPKINS UNIVERSITY · PI CAMERON, ANDREW M. · 2008 to 2024
$6.0M
Department of Health RP_2014-04-022Medical Research Council MR/M017974/1NCI NIH HHS T32 CA126607
6 · The paper itself

Abstract

backgroundThe surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool.

methodsProspective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals.

resultsWe included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32-0.77); P<0.01], but no difference in complication rates [OR 1.02 (0.88-1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62-0.92); P<0.01; I

conclusionsPatients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

Indexed as

ChecklistPatient SafetyAdultAgedCohort StudiesElective Surgical ProceduresEvidence-Based MedicineFemaleHospital MortalityHumansMaleMiddle AgedPostoperative ComplicationsPostoperative PeriodSurgical Procedures, OperativeTreatment Outcomecohort studiesoperative/mortalitypostoperative care/methodspostoperative care/statistics and numerical datasurgerysurgical procedures

Identifiers

PMID29397122
PMCPMC13168996

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.