Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/3492
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dc.contributor.authorGlobalSurg Collaborative-
dc.contributor.authorTabiri, S.-
dc.date.accessioned2022-03-24T11:26:28Z-
dc.date.available2022-03-24T11:26:28Z-
dc.date.issued2016-
dc.identifier.issn1365-2168-
dc.identifier.urihttp://hdl.handle.net/123456789/3492-
dc.description.abstractBackground: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emer- gency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role.en_US
dc.language.isoenen_US
dc.publisherJohn Wiley & Sons Ltd.en_US
dc.relation.ispartofseriesVol 103;Issue 8-
dc.titleMORTALITY OF EMERGENCY ABDOMINAL SURGERY IN HIGH- MIDDLE AND LOW-INCOME COUNTRIESen_US
dc.typeArticleen_US
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