Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Measurement of CP-Violating Asymmetries in B0 Decays to CP Eigenstates

We present measurements of time-dependent CP-violating asymmetries in neutral B decays to several CP eigenstates. The measurement uses a data sample of 23×10^6 ϒ(4S)→BB̅ decays collected by the BABAR detector at the PEP-II asymmetric B Factory at SLAC. In this sample, we find events in which one neutral B meson is fully reconstructed in a CP eigenstate containing charmonium and the flavor of the other neutral B meson is determined from its decay products. The amplitude of the CP-violating asymmetry, which in the standard model is proportional to sin2β, is derived from the decay time distributions in such events. The result is sin2β = 0.34±0.20(stat)±0.05(syst)

The BaBar detector

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Measurement of time-dependent CP asymmetries and the CP-odd fraction in the decay B-0 -> D*+D*- RID C-2728-2008 RID C-5223-2009 RID C-5719-2008 RID D-1055-2009 RID A-2675-2009

We present a measurement of time-dependent CP asymmetries and an updated determination of the CP-odd fraction in the decay B-0-->D*+D*- using a data sample of 88x10(6)B (B) over bar pairs collected by the BABAR detector at the PEP-II B Factory at SLAC. We determine the CP-odd fraction to be 0.063+/-0.055(stat)+/-0.009(syst). The time-dependent CP asymmetry parameters Im(lambda(+)) and \lambda(+)\ are determined to be 0.05+/-0.29(stat)+/-0.10(syst) and 0.75+/-0.19(stat)+/-0.02(syst), respectively. The standard model predicts these parameters to be -sin2beta and 1, respectively, in the absence of penguin diagram contributions

Observation of a narrow meson state decaying to D-s(+)pi(0) at a mass of 2.32 GeV/c(2) RID C-2728-2008 RID C-5223-2009 RID C-5719-2008 RID D-1055-2009 RID A-2675-2009

We have observed a narrow state near 2.32 GeV/c(2) in the inclusive D(s)(+)pi(0) invariant mass distribution from e(+)e(-) annihilation data at energies near 10.6 GeV. The observed width is consistent with the experimental resolution. The small intrinsic width and the quantum numbers of the final state indicate that the decay violates isospin conservation. The state has natural spin-parity and the low mass suggests a J(P)=0(+) assignment. The data sample corresponds to an integrated luminosity of 91 fb(-1) recorded by the BABAR detector at the SLAC PEP-II asymmetric-energy e(+)e(-) storage ring

Measurement of B0 ---> D(*)+ D*- branching fractions and B0 ---> D*+(s) D*- polarization with a partial reconstruction technique

We present a study of the decays B0->D_s(*)+D*-, using 20.8 fb-1 of e+e- annihilation data recorded with the BABAR detector. The analysis is conducted with a partial reconstruction technique, in which only the D_s(*)+ and the soft pion from the D*- decay are reconstructed. We measure the branching fractions BR(B0->D_s+D*-) = (1.03 +/- 0.14 +/- 0.13 +/- 0.26)% and BR(B0->D_s*+D*-) = (1.97 +/- 0.15 +/- 0.30 +/- 0.49)%, where the first error is statistical, the second is systematic, and the third is the error due to the D_s+->phi pi+ branching fraction uncertainty. From the B0->D_s*+D*- angular distributions, we measure the fraction of longitudinal polarization Gamma_L/Gamma = (51.9 +/- 5.0 +/- 2.8)%, which is consistent with theoretical predictions based on factorization.Comment: 9 pages, 4 postscript figues, submitted to Physical Review D (Rapid Communications