Impacts of the Surgical Safety Checklist on Postoperative Clinical Outcomes in Gastrointestinal Tumor Patients: A Single-center Cohort Study

Hao Wang, Shougen Cao, Xiaobin Zhou, Shikuan Li, Zhaojian Niu, Dong Chen, Dongsheng Wang, Shanglong Liu and Yanbing Zhou

Department of General Surgery, Dongying People’s Hospital, China
Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, China
Department of Epidemiology and Health Statistics, Qingdao University Medical College, China

^*Correspondance to: Shougen Cao 

 PDF  Full Text DOI: 10.25107/2474-1647.2311

Abstract

Background: A 19-item Surgical Safety Checklist (SSC) was published by the World Health Organization in 2008 and was proved to reduce postoperative complications. To date, however, the impacts of SSC implementation in China have not been evaluated clearly. The study was performed to evaluate the impacts of the SSC on postoperative clinical outcomes in gastrointestinal tumor patients.Study
Design: Between April 2007 and March 2013, 7,209 patients with gastrointestinal tumor who underwent elective surgery at the Affiliated Hospital of Qingdao University were studied. Data on the clinical records and outcomes of 3,238 consecutive surgeries prior to SSC implementation were retrospectively collected; data on another 3,971 consecutive surgeries performed after implementation of the checklist system was prospectively collected. The clinical outcomes (including mortality, morbidity, readmission, reoperation, unplanned intervention and postoperative hospital stay) within postoperative 30 days were compared between the two groups. Univariate and multivariate logistic regression analysis were performed to identify independent factors for postoperative complications.Results: The rates of morbidity and in-hospital mortality prior to and after checklist implementation were 16.43% vs. 14.33% (P=0.018), 0.46% vs. 0.18% (P=0.028), respectively. Median of postoperative hospital stay before checklist implementation was 1 day longer than that observed afterward (P<0.001). Multivariable analysis demonstrated that the SSC was an independent factor influencing any postoperative complications (odds ratio =0.860; 95% CI, 0.750 to 0.988).Conclusion: Implementation of the SSC could improve the clinical outcomes in gastrointestinal tumor patients undergoing general surgery in China.

Keywords

Gastrointestinal neoplasms; General surgery; Surgical safety checklist

Cite the article

Wang H, Cao S, Zhou X, Li S, Niu Z, Chen D, et al. Impacts of the Surgical Safety Checklist on Postoperative Clinical Outcomes in Gastrointestinal Tumor Patients: A Single-center Cohort Study. Clin Surg. 2019; 4: 2311.