European Surgical Outcomes Study (EuSOS), published in The Lancet on September 21, 2012; revealed that non-cardiac surgical mortality was higher than previous estimates, in some European countries. For example, surgical mortality is 3.6 per cent in the UK as against the earlier national estimates of one to two per cent. What is more alarming is the fact that 73 per cent of those who lost their lives had not been admitted to critical care wards post-surgery. 43 per cent of those who were admitted to critical care after surgery, died after being transferred to a regular ward. Moreover, the overall European surgical mortality figure of four per cent contrasts sharply with the two per cent mortality following emergency cardiac surgery, in which admission to critical care is generally standard. The European Society of Anaesthesiology (ESA) stated that these revelations raises doubts over the allocation of vital facilities in hospitals across Europe and has called for new research into how to improve the surgical outcomes of patients, including better ways of monitoring and preventing complications in those at highest risk of death.
“Of particular concern to ESA is that the study reveals that critical care resources do not appear to be allocated to the patients at highest risk of death,” said Professor Andreas Hoeft, Chairman of ESA’s Research Committee and co-author on The Lancet paper.
“Simply calling for more intensive care unit (ICU) beds will not solve the problem. No health system in Europe can afford to transfer all surgical patients routinely to an ICU or intermediate care, as it is current practice in cardiac surgery and most neurosurgery,” stated Hoeft and added, “New, cost-effective ways of identifying and monitoring patients at risk must be developed. These findings provide further evidence that current clinical practice fails to identify patients at risk at an early stage and to detect and treat complications early enough. We might need such cost-effective monitoring and alarm systems on regular wards in the future.” Hoeft is based at the Department of Anaesthesiology and Intensive Care Medicine, University Hospital Bonn, Germany.
Data from EuSOS was first presented in June at Euroanaethesia 2012, the annual congress of ESA. The study was funded through a joint research grant from ESA and the European Society of Intensive Care Medicine (ESICM).
Source: The Lancet
EH News Bureau