The Ethiopian Surgical Outcome Study (Ethio-SOS)
A 7-day multicentre national prospective observational cohort study
Bibliographic Data
INTRODUCTION: Safe surgical care is a cost-effective intervention for addressing a wide range of conditions, yet postoperative complications remain a leading global cause of disability, mortality and economic loss, disproportionately affecting low- and middle-income countries. This study aims to generate robust epidemiological data on postoperative outcomes for surgical patients in Ethiopia. METHOD: This 7 day national observational cohort study included adult patients undergoing elective and non-elective surgeries, using a convenience sampling method to recruit as many hospital sites as possible from all regions of Ethiopia. The primary outcomes measured were 7 day in-hospital mortality and postoperative complications. Statistical analysis included descriptive statistics and logistic regression models to identify risk factors for mortality and complications. RESULTS: A total of 4412 surgical patients across 46 Ethiopian hospitals were included in this study. The median patient age was 30 years (IQR: 25-42), with a predominance of female participants 2772/4412 (62.8%) and American Society of Anaesthesiologists (ASA) classification class I-II classifications. The overall complication rate was 19.8% (873/4412), with 4.2% (184/4412) experiencing severe complications (Clavien-Dindo grades III-IV) necessitating reoperation. The overall mortality rate was 0.4% (17/4412), with a median age at death of 40 years (IQR=29-49). Our findings suggest that the key drivers of perioperative mortality and postoperative complications were higher ASA class, comorbidities, cancer surgery, infections and emergency surgical procedures. CONCLUSION: One in five surgical patients in Ethiopia experiences postoperative complications and a high rate of reoperation, despite exhibiting a low-risk profile, young age and a low rate of high-risk surgical procedures. This suggests a need for more evidence-based interventions to strengthen the foundations, care processes and quality of the surgical system to achieve safe and effective care and improve overall surgical outcomes in the country
Cohort study · Health services research · MEDLINE · Observational study · Outcomes research · Prospective cohort study · Psychological intervention · Global Health and Surgery · Global Maternal and Child Health · Trauma and Emergency Care Studies
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement
High-quality health systems in the Sustainable Development Goals era
Quality and sustainability of Ethiopia’s national surgical indicators
The effect of comorbidity on 28-day perioperative mortality rate among non-cardiac surgical patients in Northwest Ethiopia
| Citations per year | 1 |
|---|---|
| Citation span | 2026 - 2026 (1) |
| Highly cited | No |