The Lancet medical journal has published the results of research carried out by, among others, a team from Barts and The London School of Medicine and Dentistry, Queen Mary University of London examining post-operative deaths at 500 hospitals across 28 European countries. More than 46,000 general surgery patients were monitored for up to 60 days after their operations which took place within 7 days in 2011 with a wide variation of results between nations.
Overall, the study found a post-surgery mortality rate of 4%, more than twice previous estimates and higher than anticipated. While for each nation the reasons for this are likely to be many and varied, the authors did identify admission to critical care post-operatively for those most at risk of death as appearing to be of fundamental importance. The study reports that nearly three quarters of patients (73%) who died were never admitted to critical care at any stage and indicates that critical care resources are not being allocated to patients at greatest risk. It reports that some nations have many more intensive care beds available than others with a consequent higher referral rate and a lower mortality rate post operatively.
Further research is required to understand the full implications of the study but the results demonstrate that closer cooperation across Europe and further afield can not only provide valuable healthcare information but also help identify causes and solutions to improve care for this group of patients and inform decision makers when difficult resource questions have to be addressed.
Surgery always carries risks but it is devastating for families to lose loved ones following an operation when the risk has been adjudged as low enough to be worth taking or, alternatively, necessary and unavoidable, particularly if there is a suggestion that transfer to a critical care unit might have made all the difference.