The use of global surgical guidelines has substantially reduced post-operative deaths in the Scottish NHS, a new report shows.
A team from the University of Birmingham, UK, examined the impact of the World Health Organisation Surgical Safety Checklist, which was launched in 2008 and has been widely implemented.
The looked at information on all 12,667,926 admissions to acute hospitals in Scotland between 2000 and 2014. Of these, 6,839,736 included a surgical procedure.
The overall inpatient mortality rate was 0.76% in 2000, falling to 0.46% in 2014.
Calculations suggested that use of the checklist was linked to a 36.6% reduction in mortality. The greatest reductions in mortality were seen in oesophagogastric (68.8%) and breast (69.3%) surgery.
Writing in The British Journal of Surgery, the authors add: “No such improvement trends were seen in the non-surgical cohort over this time frame.”
They conclude: “Since the implementation of the checklist, as part of an overall national safety strategy, there has been a reduction in perioperative mortality.”
The checklist was introduced in Scotland as part of the Scottish Patient Safety Programme between 2008 and 2010.
Mr Aneel Bhangu commented: "Around the world 4.2 million people die every year within 30 days after surgery – with half of these deaths occurring in low and middle income countries. Identification of strategies to reduce postoperative mortality is now a global research priority.
"It is encouraging that despite having among the lowest baseline rates globally, both Scotland and England have achieved a greater than one-third reduction in overall perioperative mortality rate. Replicating these gains internationally could avoid thousands of postoperative deaths, with the greatest potential gains in low and middle income countries."
Ramsay, G. et al. Reducing surgical mortality in Scotland by use of the WHO Surgical Safety Checklist. British Journal of Surgery 16 April 2019 doi: 10.1002/bjs.11151
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