Crude hospital mortality for all patients recruited in SASOS was 3.
Furthermore, although the critical admissions reported in SASOS were significantly fewer than in EuSOS (6.
The main findings of the SASOS critical care cohort showed that comorbidities, severity of illness and outcomes differed between planned and unplanned admissions in SA.
These two factors may therefore reflect limited critical resources and/or failure to identify at-risk postoperative patients in the SASOS cohort.
Compared with studies conducted in European, Australian and North American populations, [8,9] SASOS patients were relatively younger, consistent with the low life expectancy in SA.
By adopting the EuSOS protocol with minor modifications, SASOS provides data that are directly comparable with the EuSOS data and 28 European countries.
The SASOS data also provide external validation of the importance of non-communicable risk factors for perioperative mortality.
14] It is inappropriate to extrapolate the SASOS data to district hospitals, as although surgery may be limited in district hospitals, it is possible that the mortality is higher owing to limited resources, unmet surgical needs and a lack of provision for predominantly emergency surgery.
1] the SA population statistics for 2013  and the SASOS data, the estimated mortality of surgery in adults ([greater than or equal to] 20 years of age) in SA is between 76 and 128 deaths per 100 000, which is equivalent to 7.
SASOS suggests that the benefits associated with surgery  are compromised for a number of reasons.
Importantly, the mortality and critical care admission rate associated with urgent and emergency surgery are mainly due to factors other than injuries and violence, as injuries have little or no contribution to the attributable risk in SASOS.
The SASOS data suggest that NCDs have a larger proportional contribution to morbidity and mortality than infections and injuries.