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New Study Finds More Post-Surgery Deaths Globally Than From HIV, Tuberculosis and Malaria Combined (upi.com)
schwit1 shares a report from UPI: About 4.2 million people worldwide die every year within 30 days of surgery -- more than from HIV, tuberculosis and malaria combined, a new study reports. The findings show that 7.7 percent of all deaths worldwide occur within a month of surgery, a rate higher than that from any other cause except ischemic heart disease and stroke. "Although not all postoperative deaths are avoidable, many can be prevented by increasing investment in research, staff training, equipment and better hospital facilities," lead author of the study, Dr. Dmitri Nepogodiev, said in a university news release. Along with finding that 4.2 million people a year die within a month of having surgery, his team discovered that half of those deaths occur in low- and middle-income countries.
"Although not all postoperative deaths are avoidable, many can be prevented by increasing investment in research, staff training, equipment and better hospital facilities," Nepogodiev said in a university news release. "To avoid millions more people dying after surgery, planned expansion of access to surgery must be complemented by investment in to improving the quality of surgery around the world," he noted.
"Although not all postoperative deaths are avoidable, many can be prevented by increasing investment in research, staff training, equipment and better hospital facilities," Nepogodiev said in a university news release. "To avoid millions more people dying after surgery, planned expansion of access to surgery must be complemented by investment in to improving the quality of surgery around the world," he noted.
100% of people die within a few days of drinking water.
Compared to what? What's the number for people who die within 30 days of not having medically necessary surgery? I'm pretty sure people consider the risks pretty carefully before opting for surgery.
And yes, spending more money generally correlates with improved outcomes, but if it's not quantitative then it's not telling us anything new.
We are given these numbers without useful context - only a meaningless comparison to the total deaths caused by several historically scary diseases.
Taken as a group, surgical patients will probably be sicker, on average, than the population as a whole. What are the measured mortality rates per type of surgery? What are the expected mortality rates of these patients, both with and without surgical intervention? What is the total number of surgeries involved?
#DeleteChrome
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I suspect that increasing investment in research, staff training, equipment and better hospital facilities aren't really going to have that much impact because usually when you need surgery, you are pretty fucked up already.
This is nothing more than shilling for more cash.
"Tempers are wearing thin. Let's just hope some robot doesn't kill everybody." --Bender
This is one of the reasons why our medical system is so out of control. They routinely do complex surgeries on very, very old people who will never regain a quality of life. It doesn't matter at all that Great-Granddad is 97...let's go ahead with that heart bypass surgery.
Most people who need surgery have a medical condition in the first place. I suppose the study could be done again, with the surgery performed on perfectly healthy people, to get better data
"half of those deaths occur in low- and middle-income countries"
Which strongly suggests that half of them die in high income countries. Countries which typically have a smaller population. Which suggests that a larger proportion of high income people are dying after their surgery.
Hey, I'm talking about US, people! Tech workers, managers, skilled mathematicians and undertakers and other people who help maintain our countries' high incomes. Are we gonna stand for this death rate? We need to protest! Or move to a low-income country where surgery is safer.
...omphaloskepsis often...
I think although not all postoperative deaths are avoidable, many can be prevented by increasing investment in research, staff training, equipment and better hospital facilities.
And, I believe that although not all postoperative deaths are avoidable, many can be prevented by increasing investment in research, staff training, equipment and better hospital facilities.
The sumary says "half of those deaths occur in low- and middle-income countries"
Doesn't that mean half of those happen in rich countries? Why are they trying to shame low and middle income countries when the rate in rich countries is so high?
This 'recent' discovery is hardly proven to be true yet. At least two large studies are in progress to confirm, or reject, those early findings.
Sepsis historically has had many preliminary studies suggest a positive intervention only to be shown later it is ineffective or even harmful when studied fully. Further, even if we assume this intervention is effective, its not clear whether all three, two of the three or just one of the ingredients in necessary. We already know in some cases steroids can be helpful.
Inject-able vitamin C has plenty of history of overhyped effects followed by studies that show it has no significant effect. This is especially true as an intervention for cancer.
I wouldn't hold by breath.
In time, you may change your tune a bit once you personally know someone who goes into surgery and never wakes up.
Especially something ridiculously simple and / or routine.
No words can explain how you feel when you meet the Doctor and are expecting to hear one thing ( we're done, they're doing fine, etc. )
only to find out they coded on the table and the surgical team spent the last half hour trying to revive them to no avail.
The truly frustrating part is not knowing why.
Body just give up ? Medical / Anesthesia error ? Reaction to one of the meds ?
It's one of those things that will haunt you forever.
Find people who can study. Accept only the best people for medical work.
Make sure they can all pass their tests.
Ensure they can function in a teaching hospital with constant peer review.
Stop accepting average and mediocre students.
Make sure your nations has the best professionals every decade.
A doctor wants to work in your nation with no qualifications?
Make them pass the same standard exams before they are allowed in.
Peer review will then find the people who cant learn, who cant study, who cant keep up.
Domestic spying is now "Benign Information Gathering"
Reminds me of a quote supposedly given by Willie Sutton, a notorious bank robber. When asked why he robbed banks, he replied "because that's where the money is."
Why do people die in hospitals? Because that's where sick people go. Why do people die after surgery? Because one, surgery carries a certain risk. Two, if they are doing surgery on you, there's probably something wrong with you to begin with.
There are absolutely problems with secondary infections, surgical errors, unnecessary surgeries and the like. but a single statistic doesn't say anything about those things.
My Other Computer Is A Data General Nova III.
Drug-resistant infections are making hospitals a really dangerous place to be.
I don't agree.
I had a major surgery, planned a couple of months in advance. I was in a good condition, but if I didn't have the surgery, then it would have led to a serious condition later on. I was not "pretty fucked up".
One week after being released from hospital, I went back to the hospital's ER, due to pain and fluid leaking from the closed incision. The doctor on duty gave me a prescription for strong pain killers and sent me away.
3 days later, I was back in the same ER. A more experienced doctor knew what was wrong, and proceeded to pump out of me over a pint of smelly fluid. He also contacted one of the surgical team, who ordered tests and a CAT scan. I was admitted back into the hospital and given a course of the strongest antibiotics they had via IV. If I hadn't gone back in to the ER when I did, there was a good change I would have died.
The surgeon told me that when I first visited the ER, they should have contacted her and let her examine me. This appeared to be a standard procedure but the working doctor was not aware of this.
In my case, better training would have prevented an almost fatal outcome.
"The best part? I became an ordained minister while not wearing pants." -- CleverNickName
Medicine remains seriously adverse to inexpensive immune and nutritional methods that can make huge differences in surgical recovery and complications.
No it isn't. I don't know any self respecting doctor who wouldn't recommend a healthy diet. By healthy diet I mean the basics: avoid too much sugar, fat, salt, eat the right amount of calories, etc... They also routinely recommend avoiding or favoring some kinds of foods if you have some conditions. As for inexpensive immune methods, they are called vaccines.
The recent "discovery" that vitamin B1+hydrocortisone+a little injected vitamin C can prevent and abort sepsis is a small, belated step in the right direction. Big Medicine is still way behind on injectable vitamin C technology though.
The conclusion of that "recent discovery" is "additional studies are required to confirm these preliminary findings". Many promising preliminary studies don't pass clinical trials unfortunately. Don't claim victory too early.
Vitamin C is effective for treating scurvy, which is a now rare disease caused by the lack of vitamin C. It is a discovery that saved thousands of life in the past. But such a resounding success doesn't make vitamin C a cure-all. Other uses of vitamin C, injectable or otherwise didn't get much conclusive results despite being studied a lot (61759 results for "vitamin C" on PubMed).
If you're really going to study this for your PhD, you're sounding pretty naive about things. Screening leads to false positives as well as true positives, and positives require intervention. If you're going to intervene with every early prostate lump that's too small for a GP to feel, you're going to be intervening with a lot of people who would have done perfectly well with no intervention at all, or intervention only much later.
I mean there are reams and reams of papers written on this topic in relation to breast cancer screening, for example. Hugely difficult to figure out whether screening is a net benefit. Even more so when you start thinking about marginal spend and cost per QALY.
The general idea that prevention is better than cure, and early intervention is typically better than late intervention -- lots of evidence to support that. But it's not evidence for fancy machines, it's evidence for public health and primary care, a la the NHS before the Tories fucked it over (again).
Thinking of the last 3 deaths in my family, yes, this is pretty much true. Every single one had a surgery to attempt to stop the inevitable, and every single one died within 30 days of that. I don't really fault the doctors, they told us all ahead of time that the probability of success was very low. But when you're talking about someone definitely dying, versus the chance they will not die, you take the chance they will not die.
Now throw in "world-wide" and you are also including a lot of surgeries being done in less than ideal environments with less than ideal equipment, possibly by undertrained staff, Inevitably you end up with junk. Making a decision to do surgery should definitely be informed by the risks, but those risks are not equal in a large university hospital in Washington DC versus a tent in the sahara (possibly involving Chevy Chase and Dan Aykroyd masquerading as a doctors to avoid blowing their cover).
I would rather hear about the number of post-surgical deaths in 30 days in 1st world countries where the patient prognosis was not terminal by qualified physicians, that's information I would consider.
You're improperly comparing to a zero base state - post-surgery death vs if the person were living a normal life and didn't need surgery. That leads you to the incorrect conclusion that "something is wrong" when someone dies after surgery.
The correct comparison is is against what would've happened to the person if they hadn't gone into surgery. Except for cosmetic surgery, going to the OR is usually to treat a life-threatening problem. 4.2 million deaths after surgery vs 313 million surgical procedures is a 1.3% chance of death post-surgery. People opt for surgery because that's a helluva improvement over the ~50% chance of death if they hadn't gone into surgery.
The same miguided argument is used against vaccines. A few dozen children die from vaccines each year. Anti-vaxxers (comparing to a zero base state of no deaths) cite that as evidence that vaccines are unsafe. But the correct comparison is a few dozen deaths from vaccines, vs the tens or hundreds of thousands of deaths if nobody were vaccinated. We opt for vaccines and surgery because they're the lesser of two evils (far, far lesser).
Another example is the crash of United Airlines 232. One of the passengers was a lap child - an infant or small child carried on the parents' lap and traveling without paying for a seat. The head stewardess abroad the flight followed procedure and instructed the parents to put the lap child underneath the seat in front of them like carry-on luggage. When the child died, she was so racked with guilt that she went on a multi-decade crusade to get lap children banned. The FAA finally ruled against her a few years ago. She was incorrectly comparing against a zero base state - the lap child dying vs possibly surviving if it had been belted into a seat. The FAA made the correct comparison. Lap children are allowed because flying is two orders of magnitude safer than driving. If you forced all parents with small children to pay for a seat for those children, a lot of them would opt to drive instead of fly. And as a result a lot more children would die from car accidents than this one lap child on this one ill-fated flight.
Instead of being frustrated over not knowing why the "unnecessary" death occurred, treat it as a gamble. The patient's original status gave him, say, a 50% chance of survival. Surgery gives him a 98.7% chance of survival. So surgery is obviously the better bet and wiser choice. But 1.3% of the time you will still lose that bet. It still boils down to the luck of the draw, except with surgery (and vaccines and lap children) you are stacking the deck far, far in your favor.
We can and certainly should try to improve the 1.3% fatality rate following surgery. But 1.3% is still a good thing, not something to be ashamed or fearful of. People are making jokes because TFA is naively trying to spin this story as if surgery were an additional risk, when it's actually a reduction in risk.
Sorry, I did not realize I was communicating with a wacko. Will avoid wasting my time in the future.
As some other responses to your post have said, there's a problem with detecting too much stuff and having false, or false-ish positives.
There's a cancer researcher who has postulated that cancers show up all the time, but are mostly rejected by the immune system while still small and never really cause any problems or require any treatment.
In fact, I *think* I had a basal cell carcinoma (looked just like one, i swear) and I was on the verge of going to get it treated when it got irritated, started to bleed a bit, and then vanished over a few days. Gone. No scar. Poof. Never came back. It's been > 5 years. In my case, I would have been trading a low-risk surgery that would have left a scar with no-risk immune attack on that possible basal cell carcinoma that left no scar.
I suspect a lot of "early detections" would lead to medical interventions that caused more harm than good, and are costly. Better to put the medical resources into prenatal care and immunizations. Big bang/buck there.
Best,
--PeterM
Tell that to the 16M people who get cosmetic surgery every year â" and thatâ(TM)s just in the US.
https://www.eff.org/https-everywhere
The exact percentage is unknown, but there is some percentage of doctors who don't care at all. They fill out checklists and do the bare minimum of what those checklists prescribe in order to keep themselves from being declared incompetent... but they just don't care. They were told if they do certain things in a certain order, they get money. So they do, but they don't care. Your suffering is immaterial. Your survival has no bearing on whether or not they sleep well at night. They just don't care.
You factor that in with hospitals being a concentrated warehouse storage of some of the nastiest bacteriums on this planet and... this result is expected. I would go so far as to say that it gives an upper bound on the amount of medical professionals who just don't care. If that is the case, the numbers are better than I had hoped. Maybe it is possible to find a medical professional who does more than checklists and shoulder shrugs.
Or, maybe, this result is indicative of how good those checklists are... (now I am depressed again)
"Someone needs to talk to the tree of liberty about its ghoulish drinking problem." by ohnocitizen
Like I said huge biases. The 0 reflects actual knowledge and experimental base for you and associates, evidence of a parrot-like knowledge base.
In a world, that has growing antibiotic resistance (and some nasty, expensive antibiotics), IV vitamin C is a nice option. Ditto acute viruses. As for the cancer part, it distinctly, factionally helped us when MD Anderson types wrote someone off, and saved $ $,$$$,$$$ too. I don't claim it as a cancer panacea.
Ok, AC, I'll assume that that is a real question and all you lack is a little understanding, so I'll give you an informative answer.
It's all relative and time related.
I had a potentially fatal condition, but it was not currently fatal that that moment in time. If fact, it was the complete opposite. I waited 2 months not due to a queue or waiting list, but I waited until my condition improved and I was in good health. That's the best time to operate, when someone is in good health.
Imagine if you have a swollen appendix. If it needs to be removed, you have a better chance of survival if it hasn't yet burst. If you go in for emergency surgery with a burst appendix, then you have a lower rate of survival as your body is already reacting to the condition. If it hasn't yet burst, and you are not currently suffering from pain and infection, then the surgery is less of a shock to your body.
"The best part? I became an ordained minister while not wearing pants." -- CleverNickName