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Revista Colombiana de Cirugía

Print version ISSN 2011-7582On-line version ISSN 2619-6107

Abstract

LOZANO-SUAREZ, Nicolás et al. Perioperative mortality in Tolima and perspectives of the fourth indicator of The Lancet Commission on Global Surgery: A preliminary analysis of the prospective cohort of the Colombian Surgical Outcomes Study (ColSOS). rev. colomb. cir. [online]. 2023, vol.38, n.3, pp.501-511.  Epub Mar 21, 2023. ISSN 2011-7582.  https://doi.org/10.30944/20117582.2289.

Introduction.

Perioperative mortality accounts for 4.2 million deaths annually. The fourth indicator of The Lancet Commission on Global Surgery allows standardizing perioperative mortality. In Colombia, there are approximations based on secondary data, limiting the analysis and interventions applicable to our population. The objective of this study is to describe perioperative mortality through primary data that allow supporting public policies.

Methods.

A preliminary analysis of an observational, prospective cohort, multicenter study was carried out at six institutions in the District of Tolima. Patients undergoing surgical procedures were included for one week, for subsequent follow-up until discharge, death, or 30 days of hospitalization. Perioperative mortality was the primary outcome and was presented as a proportion.

Results.

A total of 378 patients were included, with a median age of 49 years (RIC 32-66), low-risk profile (ASA I-II 80%), and low surgical complexity (42%). The most common surgeries were Orthopedic (25.4%) and Plastic Surgery (23.3%). Postoperative complications occurred in 29.7%, the most common were ARDS and postoperative ileus. Perioperative mortality was 1.3%.

Discussion.

Perioperative mortality differed from that reported in national studies, even when the patients had a low-risk profile and low complexity of the procedures. However, it coincides with that reported internationally and brings us closer to the reality of the country.

Conclusion.

The determination of the fourth indicator is of vital importance to improving surgical care in Colombia. This is the first approach with primary data that allows us to have applicable information for our population.

Keywords : hospital mortality; surgery; postoperative complications; health care outcome assessment; public health.

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