Systematic reviews and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: mortality, morbidity, and organ failure

Impact of spinal or epidural anaesthesia on perioperative outcomes in adult noncardiac surgery: a narrative review of recent evidence

“…Identified articles were assessed for their reporting of outcome measures established by the Standardised Endpoints in Perioperative Medicine (StEP) initiative 3 according to the following domains: patient comfort and patient-centred outcomes 6 , 7 ; infection and sepsis 8 ; postoperative cancer outcomes 9 ; renal endpoints 10 ; cardiovascular outcomes 11 ; pulmonary complications 12 ; and mortality, morbidity, and organ failure. 13 Table 1 provides a description of the identified StEP domains and core outcomes.…”

Exploring the need for reconsideration of trial design in perioperative outcomes research: a narrative review

“…Despite the many approaches for a definition of perioperative medicine endpoints of morbidity and organ failure, 7 there is a need for further standardisation and use of agreeable outcomes, which often have been different in anaesthesia vs. surgery directed studies. 8 Previously, in most studies length of postoperative hospital stay has been an outcome which although relevant, is unfortunately rather nonspecific and depends on many factors other than the physiological recovery process.…”

“…Because of the plethora of different outcomes, there have recently been efforts to reach consensus definitions for standardised endpoints in perioperative medicine, 7 but with different consensus from other stakeholders with a dominant focus on specific complications and consequences. 8 Hopefully, such viewpoints may soon lead to a common consensus on how to define postoperative outcome endpoints on a procedure- and patient-specific basis.…”

“…4 , 5 Nevertheless, despite the demonstrated progress in surgical care, many studies on unimodal perioperative interventions have often failed to show appreciable clinically relevant improvements in outcomes. 6 Consequently, in recent years we have witnessed several initiatives designed to improve and standardise outcome assessment 7 , 8 and trial design [large pragmatic randomised clinical trials (RCTs), platform trials, detailed prospective cohort studies and pathophysiological mechanistic studies on postoperative organ dysfunction], all in order to accelerate a knowledge base for the development of procedure-specific outcome improvement programmes.…”

Complications and consequences: short-term harm has long-term impact

“…First, it emphasises the complexity of the benefit–harm relationship surrounding surgery. Although short- and long-term mortality remain important, and valid outcomes should be reported, 6 outcomes cannot be viewed through the binary lens of survival within a specified time period alone. Rather, clinicians must seek to understand the long-term implications of surgery and its possible complications for both patients and healthcare systems.…”