Evidence map›Paper›PMID 29947986›Full record

ArticleWorld journal of surgery2019

Implementation of the World Health Organization Surgical Safety Checklist Correlates with Reduced Surgical Mortality and Length of Hospital Admission in a High-Income Country.

Elzerie de Jager, Ronny Gunnarsson, Yik-Hong Ho

Abstract read
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In one paragraph

Article in World journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 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

21 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Effects of the application of a checklist during trauma resuscitations on ATLS adherence, team performance, and patient-related outcomes: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020
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  15. Surgical Teams' Attitudes About Surgical Safety and the Surgical Safety Checklist at 10 Years:Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

Elzerie de JagerCollege of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia. elzerie.dejager@my.jcu.edu.au.
Ronny GunnarssonResearch and Development Unit, Primary Health Care and Dental Care, Narhalsan, Southern Älvsborg county, Region Västra Götaland, Sweden.
Yik-Hong HoDiscipline of Surgery, College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe World Health Organization Surgical Safety Checklist (WHO SSC) has been widely implemented in an effort to decrease surgical adverse events. The effects of the checklist on postoperative outcomes have not previously been examined in Australia, and there is limited evidence on the effects of the checklist in the long term.

methodsA retrospective review was conducted using administrative databases to examine the effects of the implementation of the checklist on postoperative outcomes. Data from 21,306 surgical procedures, performed over a 5-year time period at a tertiary care centre in Australia where the WHO SSC was introduced in the middle of this period, were analysed using multivariate logistic regression.

resultsPostoperative mortality rates decreased from 1.2 to 0.92% [p = 0.038, OR 0.74 (0.56-0.98)], and length of admission decreased from 5.2 to 4.7 days (p = 0.014). The reduction in mortality rates reached significance at the 2-3 years post-implementation period [p = 0.017, OR 0.61 (0.41-0.92)]. The observed decrease in mortality rates was independent of the surgical procedure duration.

conclusionImplementation of the WHO SSC was associated with a statistically significant reduction in mortality and length of admission over a 5-year time period. This is the first study demonstrating a reduction in postoperative mortality after the implementation of the checklist in an Australian setting. In this study, a relatively longer period examined, comparative to previous international studies, may have allowed factors like surgical culture change to take effect.

Indexed as

ChecklistAdultAustraliaDeveloped CountriesFemaleHumansLength of StayMaleMiddle AgedMortalityPatient SafetyPostoperative ComplicationsRetrospective StudiesSurgical Procedures, OperativeTertiary Care CentersWorld Health Organization

Identifiers

PMID29947986

What OpenQuestion holds

Textmetadata
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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.