New Study Finds More Post-Surgery Deaths Globally Than From HIV, Tuberculosis and Malaria Combined (upi.com) 113
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.
That's nothing (Score:5, Insightful)
100% of people die within a few days of drinking water.
Comment removed (Score:5, Informative)
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To be pedantic, very nearly 100% of people die after water intake as well. It would appear you are damned if you do, and damned if you don't.
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100% of people die within a few days of drinking water.
Wrong.
100% of deaths are people who drank water in the days before the death.
Statistics (Score:3)
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.
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Its hard to really answer these without having access to the paper. One has to assume the actual paper itself is a bit more careful in its wording.
But often these studies have to be taken as part of a bigger picture when translated into policy simply because accounting for all variables is statistically hard. Differentiating cause , correlation and effect can be hard work! How many of these surgeries are on Cancer patients who are going to die regardless of the surgery. Often those surgeries are simply mean
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On top of that, the summary seems to be conflating causes of death such as heart disease and stroke with a correlated event: that many people who die had just recently had surgery. That doesn’t mean surgery is the cause of the death, nor does the fact that more deaths happen in poorer nations even necessarily mean that surgeries there are being done poorly. It could simply be that the patients aren’t getting into surgery early enough for it to be as effective. Perhaps preventative medicine is wo
Where It Is (Score:4, Insightful)
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.
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So is this important, or nothing at all? (Score:2)
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?
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> Facts: The sworn enemy of inbred Conservatism in 2019.
You act like liberals don't engage in constant unhinged hysterics and shameless distortion. This includes so-called "journalists" that are supposed to be "objective".
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Potentially. But there are other considerations too. Rabbi Abraham Twerski talks about this in an anecdote about his father's death. Atul Gawande wrote an entire book about it.
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Yeah, who would have thought that cutting open human beings who are probably already seriously ill might result in a slightly higher death rate than from a bunch of diseases that have all but been abolished in the developed world?
In other news, people who've been shot are found to have a higher post-shooting death rate than people who haven't been shot. Film at eleven!
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Taken as a group, surgical patients will probably be sicker, on average, than the population as a whole.
I'm keen to know the death rate if we stopped surgeries. I mean we really should stop them, they sound deadly.
huge biases against cheap and generic (Score:1)
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.
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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
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Cancer is the most difficult and marginal use for IV vitamin C. Still it saved us a lot time and money. Really lots, even just as an targetable, additive adjunct. Most people can't get IVC correctly - for dose or frequency or target - too much medical
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Sorry, I did not realize I was communicating with a wacko. Will avoid wasting my time in the future.
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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.
Re:huge biases against cheap and generic (Score:5, Informative)
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).
ntervention Often Leads to Worse Outcomes (Score:1)
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Well sure, but for all the marginal cases like tonsillectomies, there's a ton of straightforward clear benefit cases like ankle fractures. And you can't know whether intervention beats non-intervention without doing a study that involves some intervention.
Taleb spends his time talking about stuff that professionals in the fields he discusses would respond to with "no shit Sherlock"
Medical care at all costs because we can. (Score:1, Interesting)
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.
Risky for high income people ! (Score:5, Insightful)
"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.
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Or move to a low-income country where surgery is safer.
Jokes aside the downside of comparing percentages and rates without a basis. The basis here would be how many surgeries are conducted in rich countries vs poor countries.
IMHO (Score:2)
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.
mitigation is key (Score:1)
My theory... of which I recently signed up for the university to work towards a masters and Ph.D. in the topic is to detect maladies before they reach the point of requiring complex surgery. This comes from automating advanced medical practices and eliminating the simple ones. For
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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
False positives can cause more harm than good (Score:2)
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
butchers (Score:1)
I'm vindicated.
I always said surgeons are just high paid butchers.
They treat the symptoms by cutting it out, not the causes.
Bit pythonesque
no fecking science involved, just trial and error.
Half of those deaths? (Score:4, Insightful)
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?
Lots of folks making jokes (Score:3, Insightful)
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.
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I lost a family member like this, not from the surgery though... just died in regular care in post op choking on her own vomit because her bed was malfunctioning and would not move up and down and because of her stomach surgery so she could not bend up or roll over to clear her throat. She died alone, without assistance from any of the attending nurses, or family. The malfunction of the bed was known for days before the event. It terrifies me that someone can literally die, in a hospital from their own v
Re:Lots of folks making jokes (Score:4, Informative)
Dying on the OR table is extremely rare.
Anesthesia complications or surgery disasters leading to a direct fatality are 1:100.000 or less.
Those who succumb on a table usually entered the OR in a dismal condition, actively bleeding, whilst having a cardiac arrest etc etc.
Post-surgery, that's where the losses occur. Heart attacks, pneumonia, seizures, sepsis.
Not that all of them can be avoided and everybody's mindset is on minimizing them.
Your condition prior to surgery is the best predictor
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ERAS for the win.
https://jamanetwork.com/journa... [jamanetwork.com]
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In time, you may change your tune a bit once you personally know someone who goes into surgery and never wakes up.
Why would I change my tune? Do you know how many people would die if we decided to ban surgeries? We're joking about the heinous abuse of statistics, not about specific people dying.
Having experienced someone die as a result of surgery puts me in an interesting position: I could take your approach and get triggered negatively every time this topic is discussed, or I could maintain a sense of humour and go on with my life, calling out bad use of statistics and comparisons as I do.
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That's the anti-vaccine argument (Score:5, Informative)
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 [wikipedia.org]. 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.
How to fix this (Score:2)
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 ke
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All the average people who cant learn should have been rejected from that kind of university study well before been allowed to take up medicine as a profession.
Peer review the results of every surgery. What worked, what did not.
Infection control?
Medicine not working?
Another condition?
The condition was not detected until too late? How, who and why?
Keep looking into every professionals ability to work hard.
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Of course in America irrational fears of socialism win the day most times...
Fears about socialised medicine win the day EVERY time. Which is the primary cause of the US having a worse life expectancy and worse medical outcomes than Canada and Japan despite spending nearly twice as much on healthcare, exactly as you pointed out.
I am seeing it happen right before my eyes in my country (UK). We used to have a world-leading socialised healthcare system that is slowly being eroded into a US-style system by greedy right-wing politicians. It works like this: Step 1: chronically under-f
What %ge from infections? (Score:1)
Drug-resistant infections are making hospitals a really dangerous place to be.
This result is expected (Score:2)
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 facto
Re:But isn't investing in health care socialism? D (Score:4, Insightful)
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.
Re:But isn't investing in health care socialism? D (Score:5, Insightful)
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.
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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 swoll
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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 d
Re: But isn't investing in health care socialism? (Score:1)
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
Re: But isn't investing in health care socialism (Score:2)
Tell that to the 16M people who get cosmetic surgery every year â" and thatâ(TM)s just in the US.