• M Mansourati, V Kumar, M Khajanchi, M L Saha, S Dharap, R Seger, and M Gerdin Wärnberg.
• Global Health: Health Systems and Policy, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
• Br J Surg. 2018 Sep 1; 105 (10): 1274-1282.

BackgroundIndia accounts for 20 per cent of worldwide trauma mortality. Little is known about the quality of trauma surgery in an Indian setting. The aim of this study was to estimate the overall perioperative mortality rate, and to assess the association between type of acute surgical intervention and perioperative mortality among adult patients treated for trauma in an urban Indian setting.MethodsData were obtained from injured adult patients enrolled in four urban Indian hospitals during 2013-2015. Those who had surgery within 24 h of arrival at hospital were included in the analysis. Patients with missing data were excluded. The perioperative mortality rate was measured at 48 h and 30 days after arrival at hospital. Generalized linear mixed models were used for risk adjustment of procedure-specific mortality.ResultsAmong 2986 patients who underwent trauma surgery, the overall 48-h mortality rate was 6·0 per cent, and the 30-day mortality rate was 23·1 per cent. The highest adjusted odds ratios (ORs) for 48-h mortality were found for patients who underwent surgery on the peripheral vasculature (OR 4·71, 95 per cent c.i. 1·18 to 16·59; P = 0·030) and the digestive system and spleen (OR 3·77, 1·33 to 9·01; P = 0·010) compared with those who had nervous system surgery.ConclusionIn this study of surgery in an Indian trauma cohort, there was an excess of late perioperative deaths. Mortality differed significantly according to the type of surgery being undertaken.© 2018 BJS Society Ltd Published by John Wiley & Sons Ltd.

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