Hao Wang1,2, Shougen Cao2*, Xiaobin Zhou3, Shikuan Li2, Zhaojian Niu2, Dong Chen2, Dongsheng Wang2, Shanglong Liu2 and Yanbing Zhou2
1Department of General Surgery, Dongying People’s Hospital, China
2Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, China
3Department of Epidemiology and Health Statistics, Qingdao University Medical College, China
Background: A 19-item Surgical Safety Checklist (SSC) was published by the World Health Organization in 2008 and was proved to reduce postoperative complications. To date, however, the impacts of SSC implementation in China have not been evaluated clearly. The study was performed to evaluate the impacts of the SSC on postoperative clinical outcomes in gastrointestinal tumor patients.Study
Design: Between April 2007 and March 2013, 7,209 patients with gastrointestinal tumor who underwent elective surgery at the Affiliated Hospital of Qingdao University were studied. Data on the clinical records and outcomes of 3,238 consecutive surgeries prior to SSC implementation were retrospectively collected; data on another 3,971 consecutive surgeries performed after implementation of the checklist system was prospectively collected. The clinical outcomes (including mortality, morbidity, readmission, reoperation, unplanned intervention and postoperative hospital stay) within postoperative 30 days were compared between the two groups. Univariate and multivariate logistic regression analysis were performed to identify independent factors for postoperative complications.Results: The rates of morbidity and in-hospital mortality prior to and after checklist implementation were 16.43% vs. 14.33% (P=0.018), 0.46% vs. 0.18% (P=0.028), respectively. Median of postoperative hospital stay before checklist implementation was 1 day longer than that observed afterward (P<0.001). Multivariable analysis demonstrated that the SSC was an independent factor influencing any postoperative complications (odds ratio =0.860; 95% CI, 0.750 to 0.988).Conclusion: Implementation of the SSC could improve the clinical outcomes in gastrointestinal tumor patients undergoing general surgery in China.
Gastrointestinal neoplasms; General surgery; Surgical safety checklist
Wang H, Cao S, Zhou X, Li S, Niu Z, Chen D, et al. Impacts of the Surgical Safety Checklist on Postoperative Clinical Outcomes in Gastrointestinal Tumor Patients: A Single-center Cohort Study. Clin Surg. 2019; 4: 2311.