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The Comparability and Utility of Perioperative Mortality Rates in Global Health
Purpose of Review
To examine the comparability and utility of perioperative mortality rate (POMR) as a key global surgery metric and the added potential for mortality review to drive continuous quality improvement.
Recent Findings
There is a wide variation in the perioperative mortality rate (POMR) reported between countries, even for the three Bellwether procedures (emergency laparotomy, emergency caesarean section, management of an open fracture) and other common procedures. Clinical registries such as the National Emergency Laparotomy Audit target high-mortality procedures. Nationally, administrative databases may be used to adjust for risk factors such as age, urgency, socio-economic status and ethnicity, as well as regional variation. To improve care, clinical governance requires practitioner, peer and multidisciplinary review of all avoidable deaths attributable to surgical disease. Appropriately messaged, POMR is a useful metric for health stakeholders and informative for National Surgical, Obstetric and Anaesthesia Plan (NSOAP).
Summary
The combination of a national database background reporting POMR and clinical governance through local peer and case review of individual mortalities is essential for improving perioperative care.
To examine the comparability and utility of perioperative mortality rate (POMR) as a key global surgery metric and the added potential for mortality review to drive continuous quality improvement.
Recent Findings
There is a wide variation in the perioperative mortality rate (POMR) reported between countries, even for the three Bellwether procedures (emergency laparotomy, emergency caesarean section, management of an open fracture) and other common procedures. Clinical registries such as the National Emergency Laparotomy Audit target high-mortality procedures. Nationally, administrative databases may be used to adjust for risk factors such as age, urgency, socio-economic status and ethnicity, as well as regional variation. To improve care, clinical governance requires practitioner, peer and multidisciplinary review of all avoidable deaths attributable to surgical disease. Appropriately messaged, POMR is a useful metric for health stakeholders and informative for National Surgical, Obstetric and Anaesthesia Plan (NSOAP).
Summary
The combination of a national database background reporting POMR and clinical governance through local peer and case review of individual mortalities is essential for improving perioperative care.
History
Journal
Current Anesthesiology ReportsPublisher
Springer HealthcareLocation
Philadelphia, Pa.Publisher DOI
ISSN
2167-6275eISSN
2167-6275Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2021, The AuthorsUsage metrics
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Bellwetheremergency laparotomy auditlow-and-middle-income countries (LMIC)mortality reviewNational Surgical, Obstetric and Anaesthesia Plans (NSOAPs)perioperative mortality ratePOMRsurgical auditScience & TechnologyLife Sciences & BiomedicineAnesthesiologyLowand middle-income countries (LMIC)National SurgicalObstetric and Anaesthesia Plans (NSOAPs)MIDDLE-INCOME COUNTRIESSURGICAL MORTALITYPROSPECTIVE COHORTLANCET COMMISSIONCESAREAN DELIVERYSURGERYOUTCOMESCAREANESTHESIA
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