Imperial College London
Ben Creagh-Brown

Ben Creagh-Brown

Faculty of Medicine, National Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

b.creagh-brown08

 
 
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Location

 

Royal BromptonRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Jackson:2023:10.1016/j.bja.2022.12.012,
author = {Jackson, AIR and Boney, O and Pearse, RM and Kurz, A and Cooper, DJ and van, Klei WA and Cabrini, L and Miller, TE and Moonesinghe, SR and Myles, PS and Grocott, MPW and StEP-COMPACGroup},
doi = {10.1016/j.bja.2022.12.012},
journal = {Br J Anaesth},
pages = {404--411},
title = {Systematic reviews and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: mortality, morbidity, and organ failure.},
url = {http://dx.doi.org/10.1016/j.bja.2022.12.012},
volume = {130},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Mortality, morbidity, and organ failure are important and common serious harms after surgery. However, there are many candidate measures to describe these outcome domains. Definitions of these measures are highly variable, and validity is often unclear. As part of the International Standardised Endpoints in Perioperative Medicine (StEP) initiative, this study aimed to derive a set of standardised and valid measures of mortality, morbidity, and organ failure for use in perioperative clinical trials. METHODS: Three domains of endpoints (mortality, morbidity, and organ failure) were explored through systematic literature review and a three-stage Delphi consensus process using methods consistently applied across the StEP initiative. Reliability, feasibility, and patient-centredness were assessed in round 3 of the consensus process. RESULTS: A high level of consensus was achieved for two mortality time points, 30-day and 1-yr mortality, and these two measures are recommended. No organ failure endpoints achieved threshold criteria for consensus recommendation. The Clavien-Dindo classification of complications achieved threshold criteria for consensus in round 2 of the Delphi process but did not achieve the threshold criteria in round 3 where it scored equivalently to the Post Operative Morbidity Survey. Clavien-Dindo therefore received conditional endorsement as the most widely used measure. No composite measures of organ failure achieved an acceptable level of consensus. CONCLUSIONS: Both 30-day and 1-yr mortality measures are recommended. No measure is recommended for organ failure. One measure (Clavien-Dindo) is conditionally endorsed for postoperative morbidity, but our findings suggest that no single endpoint offers a reliable and valid measure to describe perioperative morbidity that is not dependent on the quality of deli-vered care. Further refinement of current measures, or development of novel measures, of postoperative morbidity might improve consen
AU  - Jackson,AIR
AU  - Boney,O
AU  - Pearse,RM
AU  - Kurz,A
AU  - Cooper,DJ
AU  - van,Klei WA
AU  - Cabrini,L
AU  - Miller,TE
AU  - Moonesinghe,SR
AU  - Myles,PS
AU  - Grocott,MPW
AU  - StEP-COMPACGroup
DO  - 10.1016/j.bja.2022.12.012
EP  - 411
PY  - 2023///
SP  - 404
TI  - Systematic reviews and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: mortality, morbidity, and organ failure.
T2  - Br J Anaesth
UR  - http://dx.doi.org/10.1016/j.bja.2022.12.012
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36697275
VL  - 130
ER  -
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