The surgical burden of disease and perioperative mortality in patients admitted to hospitals in Victoria, Australia: a population-level observational study

Fehlberg, Trafford, Rose, John, Guest, Glenn and Watters, David 2019, The surgical burden of disease and perioperative mortality in patients admitted to hospitals in Victoria, Australia: a population-level observational study, BMJ open, vol. 9, no. 5, doi: 10.1136/bmjopen-2018-028671.

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Title The surgical burden of disease and perioperative mortality in patients admitted to hospitals in Victoria, Australia: a population-level observational study
Author(s) Fehlberg, Trafford
Rose, John
Guest, Glenn
Watters, DavidORCID iD for Watters, David orcid.org/0000-0002-5742-8417
Journal name BMJ open
Volume number 9
Issue number 5
Total pages 9
Publisher BMJ Open
Place of publication London, Eng.
Publication date 2019-05-17
ISSN 2044-6055
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
HEALTH-CARE
SURGERY
DELIVERY
OUTCOMES
DATABASES
COUNTRIES
SERVICE
EUROPE
ACCESS
INCOME
epidemiology
health policy
public health
Summary Objectives Comprehensive reporting of surgical disease burden and outcomes are vital components of resilient health systems but remain under-reported. The primary objective was to identify the Victorian surgical burden of disease necessitating treatment in a hospital or day centre, including a thorough epidemiology of surgical procedures and their respective perioperative mortality rates (POMR). Design Retrospective population-level observational study. Setting The study was conducted in Victoria, Australia. Access to data from the Victorian Admitted Episodes Dataset was obtained using the Dr Foster Quality Investigator tool. The study included public and private facilities, including day-case facilities. Participants From January 2014 to December 2016, all admissions with an International Statistical Classification of Diseases-10 code matched to the Global Health Estimates (GHE) disease categories were included. Primary and secondary outcome measures Admissions were assigned a primary disease category according to the 23 GHE disease categories. Surgical procedures during hospitalisations were identified using the Australian Refined Diagnosis Related Groups (AR-DRG). POMR were calculated for GHE disease categories and AR-DRG procedures. Results A total of 4 865 226 admitted episodes were identified over the 3-year period. 1 715 862 (35.3%) of these required a surgical procedure. The mortality rate for those undergoing a procedure was 0.42%, and 1.47% for those without. The top five procedures performed per GHE category were lens procedures (162 835 cases, POMR 0.001%), caesarean delivery (76 032 cases, POMR 0.01%), abortion with operating room procedure (65 451 cases, POMR 0%), hernia procedures (52 499 cases, POMR 0.05%) and other knee procedures (47 181 cases, POMR 0.004%). Conclusions Conditions requiring surgery were responsible for 35.3% of the hospital admitted disease burden in Victoria, a rate higher than previously published from Sweden, New Zealand and the USA. POMR is comparable to other studies reporting individual procedures and conditions, but has been reported comprehensively across all GHE disease categories for the first time.
Language eng
DOI 10.1136/bmjopen-2018-028671
Indigenous content off
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30122888

Document type: Journal Article
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School of Medicine
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