TY - JOUR
T1 - Outcomes of elective liver surgery worldwide
T2 - a global, prospective, multicenter, cross-sectional study
AU - Malago, Massimo
AU - Serrablo, Alejandro
AU - Raptis, Dimitri Aristotle
AU - Dervenis, Christos
AU - Oldhafer, Karl Jurgen
AU - Machado, Marcel Autran
AU - Kokudo, Norihiro
AU - Line, Pal-Dag
AU - Hernandez-Alejandro, Roberto
AU - Breitenstein, Stefan
AU - van Gulik, Thomas
AU - Tokat, Yaman
AU - Neumann, Ulf Peter
AU - Borakati, Aditya
AU - Monaco, Andrea
AU - Schnitzbauer, Andreas A.
AU - Elfrink, Arthur
AU - Buis, Carlijn
AU - Salinas, Camila Hidalgo
AU - Imber, Charles
AU - Ferraro, Daniele
AU - Balci, Deniz
AU - Schadde, Erik
AU - Soggiu, Fiammetta
AU - Lurje, Georg
AU - Stavrou, Gregor A.
AU - Passas, Ioannis
AU - Pape, James
AU - Bemelmans, Marc
AU - de Boer, Marieke
AU - Madadi-Sanjani, Omid
AU - Olthof, Pim
AU - Koti, Rahul
AU - Gilg, Stefen
AU - Damink, Steven Olde
AU - Lang, Sven
AU - Pissanou, Theodora
AU - Hanna, Thomas
AU - Ardiles, Victoria
AU - Mostefa, Ahmed Belhadj
AU - Goransky, Jeremias
AU - McCormack, Lucas
AU - Resio, Nicolas
AU - Petrou, George
AU - Hugh, Thomas
AU - Lam, Vincent
AU - Gruenberger, Thomas
AU - Shcherba, Aliaksei
AU - Bertrand, Claude
AU - D'Hondt, Mathieu
AU - Et al.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Background:The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes.Methods:LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January-December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien-Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141).Results:A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively.Conclusions:This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives.
AB - Background:The outcomes of liver surgery worldwide remain unknown. The true population-based outcomes are likely different to those vastly reported that reflect the activity of highly specialized academic centers. The aim of this study was to measure the true worldwide practice of liver surgery and associated outcomes by recruiting from centers across the globe. The geographic distribution of liver surgery activity and complexity was also evaluated to further understand variations in outcomes.Methods:LiverGroup.org was an international, prospective, multicenter, cross-sectional study following the Global Surgery Collaborative Snapshot Research approach with a 3-month prospective, consecutive patient enrollment within January-December 2019. Each patient was followed up for 90 days postoperatively. All patients undergoing liver surgery at their respective centers were eligible for study inclusion. Basic demographics, patient and operation characteristics were collected. Morbidity was recorded according to the Clavien-Dindo Classification of Surgical Complications. Country-based and hospital-based data were collected, including the Human Development Index (HDI). (NCT03768141).Results:A total of 2159 patients were included from six continents. Surgery was performed for cancer in 1785 (83%) patients. Of all patients, 912 (42%) experienced a postoperative complication of any severity, while the major complication rate was 16% (341/2159). The overall 90-day mortality rate after liver surgery was 3.8% (82/2,159). The overall failure to rescue rate was 11% (82/ 722) ranging from 5 to 35% among the higher and lower HDI groups, respectively.Conclusions:This is the first to our knowledge global surgery study specifically designed and conducted for specialized liver surgery. The authors identified failure to rescue as a significant potentially modifiable factor for mortality after liver surgery, mostly related to lower Human Development Index countries. Members of the LiverGroup.org network could now work together to develop quality improvement collaboratives.
KW - failure to rescue
KW - global surgery
KW - human development index
KW - liver surgery
KW - morbidity
KW - mortality
KW - outcomes
KW - RESECTION
KW - HEPATECTOMY
KW - FAILURE
KW - RESCUE
KW - BENIGN
KW - COHORT
KW - HEALTH
KW - IMPACT
KW - INDEX
U2 - 10.1097/JS9.0000000000000711
DO - 10.1097/JS9.0000000000000711
M3 - Article
SN - 1743-9159
VL - 109
SP - 3954
EP - 3966
JO - International journal of surgery (London, England)
JF - International journal of surgery (London, England)
IS - 12
ER -