Supplementary Appendix This Appendix Formed Part of the Original Submission and Has Been Peer Reviewed
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Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: GlobalSurg Collaborative and National Institute for Health Research Global Health Research Unit on Global Surgery. Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries. Lancet 2021; published online Jan 21. http://dx.doi.org/10.1016/ S0140-6736(21)00001-5. Online supplementary appendix Global variation in postoperative mortality and complications following cancer surgery: A multicentre, prospective cohort study in 82 countries GlobalSurg Collaborative and NIHR Global Health Research Unit on Global Surgery* * Investigators listed in online supplementary appendix. Table of Contents Supplementary tables and figures ....................................................................................................................................................... 2 Table S1. Patient and operative characteristics by country income group stratified by cancer type, including missing data. .......... 2 Figure S1. Missing values map. Missing values for main explanatory and dependent variables by observation. ............................. 3 Figure S2. Stage of presentation, 30-day mortality, and 30-day complications by cancer and country income group. .................... 4 Figure S3. Proportion of all patients who sustained specific complications, stratified by cancer-type and country income group. 5 Figure S4. Adjusted proportion of patients dying or sustaining a major complication or any complication by day 30 after surgery stratified by country income group. .................................................................................................................................................... 6 Figure S5. Method of determination of 30-day follow-up variables and basis for cancer diagnosis stratified by cancer type and country income group. ........................................................................................................................................................................ 7 Table S2. Stage of presentation by region. ......................................................................................................................................... 8 Table S3A. Cancer stage by other predictors (breast). ....................................................................................................................... 9 Table S3B. Cancer stage by other predictors (colon). ...................................................................................................................... 11 Table S3C. Cancer stage by other predictors (gastric). .................................................................................................................... 13 Figure S6A. Comparison between preoperative clinical and postoperative final pathological staging. .......................................... 15 Figure S6B. Capacity to rescue from major complication: sensitivity analysis using postoperative final pathological staging. .... 16 Table S4A. Surgical procedure (breast). ........................................................................................................................................... 17 Table S4B. Surgical procedure (colorectal). ..................................................................................................................................... 18 Table S4C. Surgical procedure (gastric). .......................................................................................................................................... 19 Table S5. Detailed outcomes stratified by cancer and country income level. .................................................................................. 20 Table S6A. Breast cancer logistic regression analyses: 30-day mortality. ....................................................................................... 22 Table S6B. Breast cancer logistic regression analyses: major complication. ................................................................................... 23 Table S6C. Breast cancer logistic regression analyses: all complications. ....................................................................................... 25 Table S7A. Colorectal cancer logistic regression analyses: mortality. ............................................................................................. 27 Table S7B. Colorectal cancer logistic regression analyses: major complication. ............................................................................ 29 Table S7C. Colorectal cancer logistic regression analyses: all complications. ................................................................................ 31 Table S8A. Gastric cancer logistic regression analyses: mortality. .................................................................................................. 33 Table S8B. Gastric cancer logistic regression analyses: major complication. ................................................................................. 35 Table S8C. Gastric cancer logistic regression analyses: all complications. ..................................................................................... 37 Table S9. Complications in patients who died. ................................................................................................................................ 39 Figure S7. Hospital type and facilities for centres treating colorectal and gastric cancer, stratified by country income group. ..... 41 Table S10. Summary of hospital care services for centres treating gastric and colon cancer stratified by country income group. 42 Table S11. 30-day mortality in patients who sustained a major complication. ................................................................................ 43 Table S12. 3-way mediation decomposition of proportion of effect of country income group on 30-day mortality mediated by the absence of postoperative care infrastructure. .................................................................................................................................... 44 Table S13. Absolute risk difference for 30-day mortality after major complication in the presence of consistently available postoperative care infrastructure.. ..................................................................................................................................................... 45 Independent validation study ............................................................................................................................................................. 47 Case ascertainment ........................................................................................................................................................................... 47 Figure S8. Distribution of patients enrolled per hospital in validation sample. ............................................................................... 47 Figure S9. Case ascertainment. ......................................................................................................................................................... 48 Data accuracy .................................................................................................................................................................................... 49 Table S14. Availability of sampled variables to validators by country income group. .................................................................... 49 Table S15. Validation study for continuous variable ....................................................................................................................... 50 Figure S10. Correlation of patient age in validation vs primary datasets (n=4520) ......................................................................... 50 Table S16. Validation study for categorical variables ...................................................................................................................... 51 Authorship ........................................................................................................................................................................................... 52 Writing group .................................................................................................................................................................................... 52 Contributions .................................................................................................................................................................................... 53 Conflicts of interest ........................................................................................................................................................................... 54 National Leads .................................................................................................................................................................................. 54 Local Collaborators ........................................................................................................................................................................... 55 Data Validators ................................................................................................................................................................................. 68 1 Supplementary tables and figures