Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study
| Autor: | GlobalSurg Collaborative |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Adolescent Clinical Trials and Supportive Activities Clinical Sciences GlobalSurg Collaborative Young Adult Postoperative care Postoperative complications Laparoscopic Risk Factors Clinical Research 80 and over Humans Appendectomy Prospective Studies Child Propensity Score Developing Countries Aged Developed Countries Middle Aged Appendicitis Global surgery Treatment Outcome Operative standards Laparoscopy Female Surgery Emergencies Surgical site infection Follow-Up Studies |
| Zdroj: | Surgical endoscopy, vol 32, iss 8 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | BackgroundAppendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide.MethodsThis is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6months was conducted. Follow-up lasted 30days.Results4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p |
| Databáze: | OpenAIRE |
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