Improving Perioperative Outcomes: Lessons from Ethiopia

An Ethiopian perioperative cohort signals a significant safety gap after abdominal surgery.

This retrospective national clinical audit of NaPQIN registry data included 3,226 abdominal surgery patients. Primary endpoints were perioperative complications and 30‑day mortality, and multivariable models identified associated risk factors. The dataset reports registry-derived demographics, procedure types, and standardized outcome definitions, offering robust national incidence estimates.

The overall perioperative complication rate was 9.0% (290/3,226), and the 30‑day mortality was 1.50% (48/3,226). In adjusted analyses, hypertension (adjusted OR 2.61, 95% CI 1.53–4.46) and cancer (adjusted OR 2.53, 95% CI 1.45–4.40) were independently associated with higher odds of postoperative complications. Checklist uptake was high (91.49%), yet checklist presence alone did not abolish the excess risk linked to patient-level factors.

Priority actions emerging from the audit include targeted preoperative blood-pressure optimization, development of cancer-specific perioperative pathways that incorporate oncology input and heightened monitoring, focused intra‑ and postoperative surveillance for identified high-risk patients, and routine audits of checklist fidelity linked to registry metrics.