There are fresh calls for efforts to ensure that planned expansion of access to surgery worldwide is undertaken in tandem with initiatives to reduce post-operative deaths.
In a letter in the Lancet, researchers at the UK National Institute for Health Research Global Health Research Unit on Global Surgery describe how expansion of surgical services could lead to significant increases in total global deaths.
They analysed available information to estimate 30-day post-operative mortality based on surgical volume, case-mix and post-operative death rates, adjusted for country income.
They estimated that at least 4.2 million people worldwide die within 30 days of surgery annually, with half of these deaths in low- and middle-income countries (LMICs). The figure exceeds the number of deaths from HIV, tuberculosis and malaria combined, at 2.97 million deaths.
“We project that an expansion of surgical services to address unmet need would increase total global deaths to 6.1 million annually, of which 1.9 million deaths would be in LMICs,” the authors say. “Funders and policymakers should prioritise research that aims to make surgery safer, particularly in LMICs,” they add.
They say the routine measurement of surgical outcomes is essential to monitoring global progress in addressing the burden of post-operative deaths.