ArticleInternational journal of surgery (London, England)2020
Trauma of major surgery: A global problem that is not going away.
Article in International journal of surgery (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 131 papers, 5 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.
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.
Impact of Carbohydrate Ingestion Prior to Urologic Surgery to Improve Patient Outcomes
Biological and Clinical Underpinnings of Postoperative Pain - Colorectal Surgery (BAC-UPP 2 Study)
Biological and Clinical Underpinnings of Postoperative Pain - Mastectomy (BAC-UPP 1 Study)
A Box Breathing Intervention and the Surgical Stress Response in Older Adults Undergoing Total Knee Arthroplasty: A Randomized Controlled Feasibility Trial
Who cites it
131 citing papers in PubMed, 5 syntheses or guidelines pooled it, 296 citations in OpenAlex.
- Pooled it
- Cyclooxygenase 2 Inhibitors for Headache After Elective Cranial Neurosurgery: Results from a Systematic Review of Efficacy of Cyclooxygenase 2 Inhibitors for Headache After Acute Brain Injury.Neurocritical care · 2025Pooled it
- Effects of neostigmine on postoperative neurocognitive dysfunction: a systematic review and meta-analysis.Frontiers in neuroscience · 2025Pooled it
- Role of vitamin D supplementation in modifying outcomes after surgery: a systematic review of randomised controlled trials.BMJ open · 2024Pooled it
- Pooled it
- A multimodal prehabilitation class for Enhanced Recovery After Surgery: a pragmatic randomised type 1 hybrid effectiveness-implementation trial.British journal of anaesthesia · 2026Trial
- Erector spinae plane block (ESPB) vs. pericapsular nerve group (PENG) block in total hip arthroplasty in elderly patients: a randomized, double-blinded, controlled trial.Anaesthesiology intensive therapy · 2025Trial
- Effect of intraperitoneal ropivacaine during and after cytoreductive surgery on time-interval to adjuvant chemotherapy in advanced ovarian cancer: a randomised, double-blind phase III trial.British journal of anaesthesia · 2025Trial
- Hypotension prediction index guided versus conventional goal directed therapy to reduce intraoperative hypotension during thoracic surgery: a randomized trial.BMC anesthesiology · 2023Trial
- MR-107A-02 in Acute Postoperative Pain Management Following Bunionectomy: Results from a Multicenter, Placebo- and Active-Controlled, Phase 3 Trial.Pain and therapy · 2026Article
- Decision-centered artificial intelligence for perioperative care outside the operating room: a practical review for surgeons.Journal of minimally invasive surgery · 2026Review
- The Initiation of Laparoscopic Gastric Surgery in an Academic Hospital in Greece: Early Results.Cureus · 2026Article
- A feasibility and preliminary effectiveness study of a tiered gynecological laparoscopic training curriculum in southwestern China.BMC medical education · 2026Article
- Knowledge, attitudes, and practices toward postoperative fatigue syndrome among postoperative patients.Scientific reports · 2026Article
- Autonomic Signature-Driven Anesthesia Depth Monitoring with Biomimetic Wearable ECG and Knowledge Graph-Augmented Deep Networks.Sensors (Basel, Switzerland) · 2026Article
- Article
- Prehabilitation before pancreatoduodenectomy: results of a retrospective single-center study.Perioperative medicine (London, England) · 2026Article
- Perioperative Considerations for Orthopedic Surgery in a Geriatric Population.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2026Review
- Impact of Preoperative Functional Capacity on Postoperative Mortality and Morbidity: A Prospective Cohort Study.Anesthesiology · 2026Article
- Review
71 more citing papers are in PubMed but not listed here.
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
Globally, a staggering 310 million major surgeries are performed each year; around 40 to 50 million in USA and 20 million in Europe. It is estimated that 1-4% of these patients will die, up to 15% will have serious postoperative morbidity, and 5-15% will be readmitted within 30 days. An annual global mortality of around 8 million patients places major surgery comparable with the leading causes of death from cardiovascular disease and stroke, cancer and injury. If surgical complications were classified as a pandemic, like HIV/AIDS or coronavirus (COVID-19), developed countries would work together and devise an immediate action plan and allocate resources to address it. Seeking to reduce preventable deaths and post-surgical complications would save billions of dollars in healthcare costs. Part of the global problem resides in differences in institutional practice patterns in high- and low-income countries, and part from a lack of effective perioperative drug therapies to protect the patient from surgical stress. We briefly review the history of surgical stress and provide a path forward from a systems-based approach. Key to progress is recognizing that the anesthetized brain is still physiologically 'awake' and responsive to the sterile stressors of surgery. New intravenous drug therapies are urgently required after anesthesia and before the first incision to prevent the brain from switching to sympathetic overdrive and activating secondary injury progression such as hyperinflammation, coagulopathy, immune activation and metabolic dysfunction. A systems-based approach targeting central nervous system-mitochondrial coupling may help drive research to improve outcomes following major surgery in civilian and military medicine.
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Identifiers
What OpenQuestion holds
Registered trials
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.