Perioperative mortality in low-, middle-, and high-income countries: Protocol for a multi-level meta-regression analysis.

Autor: McIntyre KJ; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.; Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada., Choi YH; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada., John-Baptiste A; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.; Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.; Interfaculty Program in Public Health, Western University, London, Ontario, Canada., Lizotte DJ; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.; Interfaculty Program in Public Health, Western University, London, Ontario, Canada., Chan EYS; Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.; School of Medicine, The Chinese University of Hong Kong, Shenzhen, Guangdong, P. R. China., Moodie J; Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada., Stranges S; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.; Department of Medicine, Western University, London, Ontario, Canada.; Department of Family Medicine, Western University, London, Ontario, Canada.; Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy., Martin J; Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.; Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Nov 01; Vol. 19 (11), pp. e0288888. Date of Electronic Publication: 2024 Nov 01 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0288888
Abstrakt: Background: Surgery is an indispensable component of a functional healthcare system. To date there is limited information regarding how many people die during the perioperative period globally. This study describes a protocol for a systematic review and multilevel meta-regression to evaluate time trends regarding the odds of perioperative mortality among adults undergoing a bellwether surgical procedure while accounting for higher order clustering at the national level.
Methods: Published studies reporting the number of perioperative deaths from bellwether surgical procedures among adults will be identified from MEDLINE, Embase, Cochrane CENTRAL, LILACS and Global Index Medicus. The primary outcome will be the rate of perioperative mortality across time and the secondary outcome will be investigating cause of death over time as a proportion of overall perioperative mortality. Two reviewers will independently conduct full text screening and extract the data. Disagreements will first be resolved via consensus. If consensus cannot be reached a third reviewer will be included to arbitrate. Due to human resource limitations, a risk of bias appraisal will not be conducted. From the included studies a multilevel meta-regression will be constructed to synthesize the results. This model will conceptualize patients as nested in studies which are in turn nested within countries while taking into account potential confounding variables at all levels.
Discussion: The systematic review and multilevel meta-regression that will be conducted based on this protocol will provide synthesized global evidence regarding the trends of perioperative mortality. This eventual study may help policymakers and other key stakeholders with benchmarking surgical safety initiatives as well as identify key gaps in our current understanding of global perioperative mortality.
Trial Registration: Systematic review registration: PROSPERO registration number 429040.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 McIntyre et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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