A surgical safety checklist to reduce morbidity and mortality in a global population

Abstract

Surgical care is an integral part of health care throughout the world, with an estimated 234 million operations performed annually.1 This yearly volume now exceeds that of childbirth.2 Surgery is performed in every community: wealthy and poor, rural and urban, and in all regions. The World Bank reported that in 2002, an estimated 164 million disability-adjusted life-years, representing 11% of the entire disease burden, were attributable to surgically treatable conditions.3 Although surgical care can prevent loss of life or limb, it is also associated with a considerable risk of complications and death. The risk of complications is poorly characterized in many parts of the world, but studies in industrialized countries have shown a perioperative rate of death from inpatient surgery of 0.4 to 0.8% and a rate of major complications of 3 to 17%.4,5 These rates are likely to be much higher in developing countries.6-9 Thus, surgical care and its attendant complications represent a substantial burden of disease worthy of attention from the public health community worldwide.