Observational studyBMJ global health2025
The Ethiopian Surgical Outcome Study (Ethio-SOS): a 7-day multicentre national prospective observational cohort study.
Observational study in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interventions to reduce postoperative mortality in low- and middle-income countries: systematic review.The British journal of surgery · 2026Pooled it
- Evaluating bellwether surgical outcomes in Ethiopia: insights from a multicentre 7-day prospective cohort study.BMC surgery · 2026Observational
- Critical care capacity in Africa: postpandemic ICU capacity, service readiness and patient profiles across public and private hospitals in Ethiopia.BMJ global health · 2026Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSafe surgical care is a cost-effective intervention for addressing a wide range of conditions, yet postoperative complications remain a leading global cause of disability, mortality and economic loss, disproportionately affecting low- and middle-income countries. This study aims to generate robust epidemiological data on postoperative outcomes for surgical patients in Ethiopia.
methodThis 7 day national observational cohort study included adult patients undergoing elective and non-elective surgeries, using a convenience sampling method to recruit as many hospital sites as possible from all regions of Ethiopia. The primary outcomes measured were 7 day in-hospital mortality and postoperative complications. Statistical analysis included descriptive statistics and logistic regression models to identify risk factors for mortality and complications.
resultsA total of 4412 surgical patients across 46 Ethiopian hospitals were included in this study. The median patient age was 30 years (IQR: 25-42), with a predominance of female participants 2772/4412 (62.8%) and American Society of Anaesthesiologists (ASA) classification class I-II classifications. The overall complication rate was 19.8% (873/4412), with 4.2% (184/4412) experiencing severe complications (Clavien-Dindo grades III-IV) necessitating reoperation. The overall mortality rate was 0.4% (17/4412), with a median age at death of 40 years (IQR=29-49). Our findings suggest that the key drivers of perioperative mortality and postoperative complications were higher ASA class, comorbidities, cancer surgery, infections and emergency surgical procedures.
conclusionOne in five surgical patients in Ethiopia experiences postoperative complications and a high rate of reoperation, despite exhibiting a low-risk profile, young age and a low rate of high-risk surgical procedures. This suggests a need for more evidence-based interventions to strengthen the foundations, care processes and quality of the surgical system to achieve safe and effective care and improve overall surgical outcomes in the country.
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