Lancet Regional Health-Europe最新文献

{"title":"Beyond geopolitics: Greenland's suicide crisis","authors":"The Lancet Regional Health – Europe","doi":"10.1016/j.lanepe.2026.101642","DOIUrl":"10.1016/j.lanepe.2026.101642","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"62 ","pages":"Article 101642"},"PeriodicalIF":13.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood culture practices and microbiological capacity for sepsis diagnostics in Europe (2021–2022): a cross-sectional analysis of the European Sepsis Care Survey","authors":"Christian S. Scheer ,&nbsp;Evangelos J. Giamarellos-Bourboulis ,&nbsp;Djillali Annane ,&nbsp;Antonio Artigas ,&nbsp;Abdullah Tarik Aslan ,&nbsp;Gabriella Bottari ,&nbsp;Hjalmar R. Bouma ,&nbsp;Vladimir Černý ,&nbsp;Renata Curić Radivojević ,&nbsp;Ken Dewitte ,&nbsp;Daniela Filipescu ,&nbsp;Matthias Gründling ,&nbsp;Johanna Hästbacka ,&nbsp;Said Laribi ,&nbsp;Annmarie Lassen ,&nbsp;Konstantin Lebedinskii ,&nbsp;Adam Linder ,&nbsp;Jan Máca ,&nbsp;Manu L.N.G. Malbrain ,&nbsp;Gianpaola Monti ,&nbsp;Zuzanna Górska","doi":"10.1016/j.lanepe.2025.101570","DOIUrl":"10.1016/j.lanepe.2025.101570","url":null,"abstract":"<div><h3>Background</h3><div>Blood cultures (BCs) are key diagnostic elements for sepsis patients. Accurate preanalytical procedures are substantial, and results should be available as soon as possible to guide adequate antimicrobial treatment. This study aimed to evaluate BC collection practices and diagnostic capacity across European hospitals.</div></div><div><h3>Methods</h3><div>This cross-sectional survey investigated BC diagnostics in acute care hospitals across 37 European countries in the years 2021 and 2022. Analyses included BC guidelines, collection sites, number of BC sets in emergency departments (EDs), wards, and intensive care units (ICUs). We also examined transfer after collection, the use of on-site vs. external laboratories, opening hours, rapid testing capacity, and turn-around times of BCs processed in microbiology laboratories with different infrastructures.</div></div><div><h3>Findings</h3><div>Responses were collected from 907 hospitals in Europe. BC guidelines were available in 84·4% (741/878) of the hospitals. BCs were preferably collected by multiple-site sampling in EDs (62·7%, 461/735), in wards (64·0%, 513/802) and ICUs (68·5%, 518/756). One BC set was preferred in EDs in 38·4% (270/704), in wards in 40·5% (314/775), and ICUs in 34·9% (261/748). Two BC sets were preferred in EDs in 31·0% (218/704), in wards in 28·1% (218/775), and ICUs in 39·2% (293/748). 48·0% (402/838) of hospitals used on-site and 52·0% (436/838) external microbiology laboratories. Around-the-clock microbiological services were available in 10⋅0% (91/907), and rapid pathogen identification in 43·7% (396/907) of hospitals. Infrastructure with around-the-clock microbiological service and rapid testing was available in 7·4% (62/840) of hospitals, and probability of a final microbiological result within two days was highest in these hospitals compared to hospitals with limited microbiology service (for BC collected on wards: 19·6% vs. 52·7%, Odds Ratio 4·59 [95% CI 2·50–7·79], p &lt; 0·0001).</div></div><div><h3>Interpretation</h3><div>Despite the availability of BC guidelines in many hospitals, current recommendations for BC collection were often neglected. Rapid testing capacity was limited in most microbiological laboratories, and around-the-clock service for BCs was very rare. As delay in results may have a detrimental impact on patient outcomes, strategies to improve these processes are urgently needed.</div></div><div><h3>Funding</h3><div>The <span>European Sepsis Alliance</span> and a grant by Becton and Dickinson.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"62 ","pages":"Article 101570"},"PeriodicalIF":13.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to coronary angiography and revascularization in 575,247 patients with STEMI from 2012 to 2023: a retrospective population-based cohort study","authors":"Paulina E. Stürzebecher ,&nbsp;Ulrich Laufs ,&nbsp;Philip Baum ,&nbsp;Johannes Diers ,&nbsp;Armin Wiegering ,&nbsp;Konstantin Uttinger","doi":"10.1016/j.lanepe.2025.101576","DOIUrl":"10.1016/j.lanepe.2025.101576","url":null,"abstract":"<div><h3>Background</h3><div>Rapid primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction (STEMI) reduces in-hospital and long-term mortality. This study analyzes time intervals to PPCI in STEMI, risk factors for delay of PPCI, and in-hospital mortality from 2012 to 2023.</div></div><div><h3>Methods</h3><div>This is a retrospective population-based analysis of hospital billing data of adult STEMI patients receiving PPCI in Germany. The time for transport to hospital (TTH) was estimated using geographic routing. The in-hospital time to angiography (IHTA) was calculated using time coding of PPCI in patient records.</div></div><div><h3>Findings</h3><div>A total of 575,247 patients were included. The median age was 64 years, 28.5% (164,016) were female. The population with IHTA ≤60 min increased from 44.5% (22,240/49,965) in 2012 to 57.7% (24,434/42,356) in 2023 with improved TTH + IHTA ≤120 min (56.6%, 28,280/49,965, in 2012–70.2%, 29,734/42,356, in 2023). IHTA improved from median 73.1 min (IQR 25.2–186.6) in 2012 to 46.4 min (IQR 17.5–111.6) in 2023 with a stable TTH (11.4–11.9 min). Risk factors for an IHTA &gt;60 min included age, female sex, comorbidity, presentation out of regular hours, and low-volume hospitals. In-hospital mortality increased (8.8%, 4406/49,965, in 2012, 10.4%, 4822/46,203, in 2021, 10.1%, 4272/42,356, in 2023), paralleling a rise in patient age and comorbidity. Risk factors for in-hospital mortality included female sex, increased age, comorbidity, high-volume hospitals, intervention of multiple coronary arteries, weekend admission, and presentation out of regular hours. IHTA &lt;40 min (90–120 min as reference) and TTH + IHTA &lt;80 min (≥120 min as reference) reduced the risk of death.</div></div><div><h3>Interpretation</h3><div>Combining hospital billing records with geographic routing enables benchmarking of both pre- and in-hospital delays in STEMI care. In hospital delay decreased between 2012 and 2023. Important areas for improving time delays and STEMI-related mortality include the timeliness of care outside of regular hours and a focus on women, older patients, as well as individuals with comorbidities.</div></div><div><h3>Funding</h3><div>There was no funding for this project or this publication.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"62 ","pages":"Article 101576"},"PeriodicalIF":13.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental wealth and mental disorders in Norway (2006–2023): a nationwide registry-based study of 1.4 million young people","authors":"Joakim Coleman Ebeltoft ,&nbsp;Eivind Ystrøm ,&nbsp;Ziada Ayorech ,&nbsp;Espen Moen Eilertsen","doi":"10.1016/j.lanepe.2025.101567","DOIUrl":"10.1016/j.lanepe.2025.101567","url":null,"abstract":"<div><h3>Background</h3><div>Young people from families with low socioeconomic position have higher rates of mental disorders. However, wealth is underexamined despite large wealth inequity worldwide. Here, we aim to investigate the relationship between early life parental wealth and mental disorders in young Norwegians.</div></div><div><h3>Methods</h3><div>We conducted a population study of associations between early-life parental wealth and 17 diagnostic categories of mental disorders in 1.4 M children (7–12), adolescents (13–18), and young adults (19–24) observed 2006–2023. Ranked parental socioeconomic indicators at age 0–6 (wealth, income, occupation, and education) and mental disorder diagnoses (ICD-10 and ICPC-2) were obtained from Norwegian Tax, Employment, Education, and Control and Payment of Health Reimbursements registries. Estimates were derived from mean prevalences, generalised estimating equations, and sibling comparison designs.</div></div><div><h3>Findings</h3><div>Parental wealth represents a gradient in young people's mental disorders across age, sex, diagnostic categories, and cohorts. The lowest wealth quintile demonstrated 87% [95% CI = 78–96%] higher 1-year prevalence than the highest quintile. In multivariable analyses, parental wealth was the strongest predictor of mental disorders relative risk in adolescents (1.83 [1.76–1.9]) and young adults (1.92 [1.8–2.04]), while wealth (1.53 [1.46–1.6]) and education (1.52 [1.45–1.6]) were the strongest predictors in children. Parental wealth has a significant within-family association with mental disorders (relative risks: children 1.57 [1.44–1.71], adolescents 1.34 [1.26–1.42], young adults 1.42 [1.31–1.54]).</div></div><div><h3>Interpretation</h3><div>Our study serves as a point of reference for understanding the relationship between parental wealth and mental health. Our findings establish early life parental wealth as a fundamental social gradient in young people's mental disorders.</div></div><div><h3>Funding</h3><div><span>European Research Council</span> consolidator grant (#<span><span>101045526</span></span>).</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"62 ","pages":"Article 101567"},"PeriodicalIF":13.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145885246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Viral infections and invasive group a streptococcal disease incidence during 2022–2023","authors":"Rosalie Lear,&nbsp;Shiranee Sriskandan,&nbsp;Tom Parks","doi":"10.1016/j.lanepe.2025.101581","DOIUrl":"10.1016/j.lanepe.2025.101581","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101581"},"PeriodicalIF":13.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Medicines Agency approvals of new medicines in November and December 2025","authors":"Bruno Sepodes ,&nbsp;Juan Garcia Burgos ,&nbsp;Steffen Thirstrup","doi":"10.1016/j.lanepe.2025.101582","DOIUrl":"10.1016/j.lanepe.2025.101582","url":null,"abstract":"","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101582"},"PeriodicalIF":13.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146187307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening antimicrobial resistance governance in Europe: a coordinated one health approach","authors":"Benjamin Davido ,&nbsp;Sofia Ny ,&nbsp;Corine van Lingen ,&nbsp;Christine Årdal ,&nbsp;Laura Alonso Irujo ,&nbsp;Sofia Linnros ,&nbsp;Lucie Collineau ,&nbsp;Nerea Gonzalez Hernandez ,&nbsp;Marta Gutierrez Rubio ,&nbsp;Giel van de Laar ,&nbsp;Lida Politi ,&nbsp;Brian Kristensen ,&nbsp;Ana Álvarez-Fernández ,&nbsp;Yohann Lacotte ,&nbsp;Agathe Claude ,&nbsp;Marie-Cécile Ploy","doi":"10.1016/j.lanepe.2025.101540","DOIUrl":"10.1016/j.lanepe.2025.101540","url":null,"abstract":"<div><div>Antimicrobial resistance (AMR) causes over 35,000 deaths annually in the EU/EEA and is projected to result in 1.91 million global deaths each year by 2050. The second Joint Action on Antimicrobial Resistance and Healthcare-Associated Infections (EU-JAMRAI-2), uniting 128 partners from 30 countries, represents a coordinated EU/EEA effort to curb AMR through a One Health approach. Although nearly all EU/EEA countries have an AMR National Action Plan, our initial assessment revealed that implementation remains constrained by limited resources, weak intersectoral coordination and fragmented leadership. EU-JAMRAI-2 addresses these challenges by promoting harmonized surveillance, strengthening infection prevention and control, applying behaviorally tailored stewardship interventions, ensuring sustainable access to essential antibiotics, and raising awareness among priority target audiences. By analyzing policy gaps and operational barriers, this paper underscores the need for stronger accountability and political commitment to translate strategies into sustainable action. Strengthening AMR governance through a unified European approach is essential to achieve effective, lasting progress against this silent pandemic.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101540"},"PeriodicalIF":13.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The burden of dietary risk factors in the Nordic and Baltic countries: a systematic analysis for the Global Burden of Disease Study 2023","authors":"","doi":"10.1016/j.lanepe.2025.101543","DOIUrl":"10.1016/j.lanepe.2025.101543","url":null,"abstract":"<div><h3>Background</h3><div>Detailed knowledge about the disease burden from unhealthy diet in Nordic and Baltic countries is lacking. This study quantifies and compares deaths and disability-adjusted life-years (DALYs) from dietary risks in these countries.</div></div><div><h3>Methods</h3><div>Data from the Global Burden of Disease study 2023 (GBD 2023) was used. Attributable disease burden from 15 dietary risks was analysed using the comparative risk assessment framework. Steps included: (1) estimating dietary intake; (2) assessing relative risks of dietary factors on disease endpoints; (3) determining theoretical minimum risk exposure levels (TMREL); and (4) estimating dietary risk-attributable disease burden as numbers and age-standardised rates (ASR) of deaths and DALYs.</div></div><div><h3>Findings</h3><div>Across the Nordic and Baltic countries (total population = 34,064,020), dietary risks resulted in 38,450 attributed deaths (95% uncertainty interval 10,749–59,386) and 735,284 DALYs (242,417–1,06,638) in 2023. Leading dietary risks included high intake of processed meat and low intake of fruits and whole grains. Dietary risks accounted for 24.9% of cardiovascular disease burden (5.0–37.6), 29.6% of diabetes and kidney disease burden (18.6–40.0), and 7.8% of neoplasm burden (2.9–12.1), with higher burden in the Baltic countries and Greenland than in the Nordic countries.</div></div><div><h3>Interpretation</h3><div>A substantial disease burden can be attributed to dietary risks in the Nordic and Baltic countries. Knowledge about the impact from unhealthy diet can inform targeted public health policies.</div></div><div><h3>Funding</h3><div><span>Gates Foundation and Norwegian Institute of Public Health</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101543"},"PeriodicalIF":13.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital mortality, withdrawal of life-sustaining therapy decisions and early secondary brain insults for critically ill traumatic brain injury patients in England, Wales and Northern Ireland (2009–2024): an observational cohort study","authors":"Xavier Chapalain ,&nbsp;Olivier Huet ,&nbsp;Kathryn M. Rowan ,&nbsp;Paul R. Mouncey ,&nbsp;Olivier Langeron ,&nbsp;David K. Menon ,&nbsp;David A. Harrison","doi":"10.1016/j.lanepe.2025.101538","DOIUrl":"10.1016/j.lanepe.2025.101538","url":null,"abstract":"<div><h3>Background</h3><div>Recent epidemiological studies reported conflicting results regarding mortality trends for traumatic brain injury (TBI) patients. Mortality trends for the critically ill TBI population, and their drivers of changes, remains understudied. Particularly, withdrawal of life-sustaining therapy (WLST) decisions were rarely evaluated concurrently. In this study, we aimed to describe hospital mortality and WLST trends over the past 15 years in England, Wales and Northern Ireland for TBI patients admitted to an intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>Observational cohort study, involving 235 adult ICUs participating in the Intensive Care National Audit &amp; Research Centre (ICNARC) Case Mix Programme (CMP). From April 1, 2009 to March 31, 2024, all TBI patients were included. Comparator cohorts consisted of patients with trauma, sepsis, and vascular brain injury recorded in the CMP. The primary outcome was hospital mortality. The secondary outcome was the incidence of WLST decisions. We also examined the proportion of patients experiencing predefined early secondary brain insults.</div></div><div><h3>Findings</h3><div>Of the 2,324,961 ICU admissions, we identified 45,684 unique TBI patients. Over the study period, hospital mortality for TBI patients increased from 25.6% (1021/3988) to 35.0% (1306/3727). The proportion of WLST decisions rose from 7.5% (301/4024) to 19.7% (759/3850). After adjustment for main confounders, multivariable analyses confirmed these trends. No similar trends were observed among the comparator cohorts. TBI patients were exposed to hypotension, hypocapnia, hypercapnia and hyperglycaemia in 49.8% (22,559/45,298), 29.9% (12,356/41,262), 33.6% (13,869/41,262) and 29.2% (12,127/41,505) of cases, respectively. Half of patients (50.3%, 20,747/41,265) were exposed to hypoxaemia, and this proportion increased markedly from 36.9% (1359/3684) to 61.2% (2186/3572) over time.</div></div><div><h3>Interpretation</h3><div>For critically ill TBI patients, hospital mortality and WLST decisions rates increased over time. These findings raise important questions regarding the processes and ethical frameworks underpinning WLST decisions.</div></div><div><h3>Funding</h3><div><span>UKRI</span>, <span>NIHR</span>, <span>UK Ministry of Defence</span>, <span>Alzheimer’s Research</span> UK, <span>French Society of Anaesthesiology and Critical Care</span>, <span>Gueules Cassées Foundation</span>, <span>INNOVEO donation fund</span>.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101538"},"PeriodicalIF":13.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management and Outcomes of Perioperative Care of People with Diabetes across Europe (MOPED): a prospective, observational study","authors":"Donal J. Buggy ,&nbsp;Malachy O. Columb ,&nbsp;Jeroen Hermanides ,&nbsp;Markus W. Hollmann ,&nbsp;Mark Coburn ,&nbsp;Alexander Zarbock ,&nbsp;MOPED Investigators","doi":"10.1016/j.lanepe.2025.101535","DOIUrl":"10.1016/j.lanepe.2025.101535","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of people with Diabetes Mellitus (DM) presenting for surgery is increasing. Guidelines on perioperative management are based on expert opinion with variability of practice likely. Our objective was to document perioperative management and 30-day outcomes of people with DM across Europe.</div></div><div><h3>Methods</h3><div>This was a prospective, observational study involving 89 hospitals across 21 European countries, ranging from district general to tertiary referral centres. Between January 2021 and February 2024, 6126 people with confirmed DM (any type except gestational) receiving surgery of any kind requiring anaesthesia were followed for 30 days. Centres were self-selected by anaesthesiology clinicians working there, who enrolled consecutive people with DM to a locally determined target number. There was 5936 (97%) 30-day follow-up completion. The primary outcome was Days at Home at 30 Days (DAH-30). Secondary outcomes included descriptive characteristics of perioperative management, dysglycaemia and incidence of postoperative complications.</div></div><div><h3>Findings</h3><div>There was significant variation between countries in perioperative DM management and 30-day outcomes, and variance in DAH-30 (median [range]) 26 [23–30] days, P = 0.0001). The proportion of people with DM with increased HbA1c (&gt;69 mmol mol) was higher in T1DM compared with T2DM (n = 51, 18% vs n = 388, 7%; difference 11%, 95% CI 6–17; P = 0.002). In univariate analysis, there was an association between patients with lower HbA1c &lt; 53 mmol mol⁻¹ median (25–75% range) DAH-30 = 27 days (23–29), contrasting with higher HbA1c &gt; 69 mmol mol, median DAH-30 = 25 days (20–28); difference 2.0, 95% CI 1.3–2.7; P &lt; 0.0001). This association was upheld in multivariable analysis only for patients with little blood loss.</div></div><div><h3>Interpretation</h3><div>There is a need to harmonise international practice to reduce variability in perioperative diabetes management and 30-day outcome.</div></div><div><h3>Funding</h3><div>The <span>European Society of Anaesthesiology and Intensive Care</span> (ESA-IC) funded administrative staff throughout the conduct of the study. The <span>College of Anaesthesiologists of Ireland</span> (CAI) and <span>British Journal of Anaesthesia</span> (BJA) partially contributed to data collection in Ireland and UK.</div></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":"61 ","pages":"Article 101535"},"PeriodicalIF":13.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145580502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}