HealthDay News — Implementation of a surgical safety checklist (SSC) correlated with a reduction in 90-day, but not 30-day, mortality among patients undergoing surgery, according to a study published in JAMA Surgery.

Matthias Bock, MD, from the Bolzano Central Hospital in Italy, and colleagues examined the correlation between SSC implementation and mortality rates. They retrospectively examined the outcomes of surgical procedures performed during the 6 months before (Jan. 1 to June 30, 2010; 5444 patients) and after (Jan. 1 to June 30, 2013; 5297 patients) SSC implementation.

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The researchers found that 90-day mortality was 2.4 and 2.2% before and after implementation, respectively (adjusted odds ratio [aOR], 0.73; 95% confidence interval [CI], 0.56 to 0.96; P = 0.02). Thirty-day all-cause mortality was 1.36 and 1.32%, respectively, before and after SSC implementation (aOR, 0.79; 95% CI, 0.56 to 1.11; P = 0.17). Thirty-day readmission occurred in 14.6 and 14.5% of the preimplementation and postimplementation groups, respectively (aOR, 0.90; 95% CI, 0.81 to 1.01; P = 0.79). The adjusted length of stay was significantly higher preimplementation versus postimplementation (10.4 versus 9.6 days; P < 0.001).

“The data cannot prove causality owing to the study design,” the authors write. “The implementation of SSCs was associated with a 27% reduction of the adjusted risk for all-cause death within 90 days but not within 30 days.”

The study was funded by the Public Health Care Company of South Tyrol.


Bock M, Fanolla A, Segur-Cabanac I et al. A Comparative Effectiveness Analysis of the Implementation of Surgical Safety Checklists in a Tertiary Care Hospital. JAMA Surg. 2016. doi:10.1001/jamasurg.2015.5490.