title: Impact of the perioperative care model on mortality of patients treated in general surgery wards.
abstract: BACKGROUND
  The risk of perioperative death in general surgery wards depends on many factors, including the underlying disease, type of surgical intervention and model of perioperative management. The aim of the study was to determine the reasons for major differences in mortality rates recorded in general surgery wards of the three university hospitals.
  
  
  METHODS
  The retrospective study was carried out and involved the data of 32 231 surgical patients. In one of the hospitals, postoperative patients were treated in the recovery room supervised by anaesthetists; in the remaining two, perioperative care was delivered by surgical ward staff. A multiple regression model with random effects was used to adjust for differences in three death risk groups of patients according to underlying diseases: low, moderate and high.
  
  
  RESULTS
  In the hospital with postoperative care administered by anaesthetic staff the mortality rate was 0.45 whereas in the two remaining ones with postoperative patients supervised by surgical staff - 1.86 and 2.52. In each group, increased mortality was observed among patients receiving therapy in general surgery wards after transfer from another hospital ward.
  
  
  CONCLUSIONS
  The major factor determining the mortality rates in general surgery wards is the model of perioperative management.
authors.affiliation: Department of Anaesthesiology and Intensive Therapy, Military University Hospital in Łódź, Poland. mariuszpiechota@poczta.onet.pl
authors.forename: Mariusz
authors.initials: M
authors.lastname: Piechota
mesh_terms: D017052:Hospital Mortality; D006801:Humans; D007430:Intraoperative Care / Q000401:mortality; D017146:Models, Organizational; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D011044:Poland / Q000453:epidemiology; D011182:Postoperative Care / Q000379:methods / Q000401:mortality*; D011183:Postoperative Complications / Q000401:mortality* / Q000517:prevention & control; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care; D013503:Surgery Department, Hospital / Q000458:organization & administration*