A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. The overall mortality among patients who developed complications was 2.8%. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A single definition of critical care was used for all countries.ДЄ total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay.

Secondary outcomes were death following a complication (failure to rescue) and death in hospital. The primary outcome was in-hospital complications. We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care.

Krishnaveni drummond