A meta-analysis of the efficacy of preoperative surgical safety checklists to improve perioperative outcomes
S. Afr. med. j. (Online)
;
106(6): 592-597, 2016.
Artículo
en Inglés
| AIM
| ID: biblio-1271107
ABSTRACT
BACKGROUND:
Meta-analyses of the implementation of a surgical safety checklist (SSC) in observational studies have shown a significant decrease in mortality and surgical complications.OBJECTIVE:
To determine the efficacy of the SSC using data from randomised controlled trials (RCTs).METHODS:
This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD42015017546). A comprehensive search of six databases was conducted using the OvidSP search engine.RESULTS:
Four hundred and sixty-four citations revealed three eligible trials conducted in tertiary hospitals and a community hospital; with a total of 6 060 patients. All trials had allocation concealment bias and a lack of blinding of participants and personnel. A single trial that contributed 5 295 of the 6 060 patients to the meta-analysis had no detection; attrition or reporting biases. The SSC was associated with significantly decreased mortality (risk ratio (RR) 0.59; 95% confidence interval (CI) 0.42 - 0.85; p=0.0004; I2=0%) and surgical complications (RR 0.64; 95% CI 0.57 - 0.71; petlt;0.00001; I2=0%). The efficacy of the SSC on specific surgical complications was as follows respiratory complications RR 0.59; 95% CI 0.21 - 1.70; p=0.33; cardiac complications RR 0.74; 95% CI 0.28 - 1.95; p=0.54; infectious complications RR 0.61; 95% CI 0.29 - 1.27; p=0.18; and perioperative bleeding RR 0.36; 95% CI 0.23 - 0.56; petlt;0.00001.CONCLUSIONS:
There is sufficient RCT evidence to suggest that SSCs decrease hospital mortality and surgical outcomes in tertiary and community hospitals. However; randomised evidence of the efficacy of the SSC at rural hospital level is absent
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Índice:
AIM (África)
Asunto principal:
Procedimientos Quirúrgicos Operativos
/
Cuidados Preoperatorios
/
Lista de Verificación
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio observacional
/
Revisiones Sistemáticas Evaluadas
Idioma:
Inglés
Revista:
S. Afr. med. j. (Online)
Año:
2016
Tipo del documento:
Artículo
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