South African Paediatric Surgical Outcomes Study: a 14-day prospective, observational cohort study of paediatric surgical patients
| Autor: | A. Torborg, L. Cronje, J. Thomas, H. Meyer, A. Bhettay, J. Diedericks, C. Cilliers, H. Kluyts, B. Mrara, M. Kalipa, R. Rodseth, B. Biccard, K. Allopi, U. Singh, P. Diyelela-Ndwandwa, N. Nongqo, B. Ravid, P. Anamourlis, G. Coetzee, M. Dlamini, C. Foster, P. Mogane, D. Nel, A. Oosthuizen, L. Redford, R. Murray, C. Basson, J. Joubert, N. Tshifularo, T. Els, J. Orrock, M. Muthambi, T. Matebesi, G. Tshukudu, D. Maela, N. Allorto, J. Bertie, D. Bishop, K. Chetty, M. Grobbelaar, R. Wise, I. von Steiger, P. Nundlal, E. Garoufalias, G. Westcott, J. Davids, C. Rajah, C. Cairns, Y. Mzoneli, K. Bhagwan, E. Cloete, M. Jaworska, E. Semenya, O. Porrill, R. Mungar, P. Seonandan, N. Perumal, C. Alphonsus, M. Bosman, A. De Castro, L. Drummond, M. Du Bruyn, P. Govender, T. Hardcastle, Z. Hlangu, P. Jeena, M. Mbuyisa, T. Naidu, J. Sewlall, J. Taylor, K. Timakia, W. Van der Walt, T. Biyase, Z. Khumalo, B. Kusel, I. Mukama, M. Ramburuth, S. Singaram, M. Mbeki, H. Schutte, P. Anderson, B. Dorasamy, P. Kint, S. Goga, L. Cronjé, N. Dube, S. Jithoo, L. Naidoo, L. Naidu, T. Reddy, Y. Saman, D. Rungan, K. Naidoo, K. Kabambi, N. Mgoqo, M. Mofoka, A. Usenbo, C. Chiu, N. Machere, D. Maiwald, G. Davies, T. Serdyn, P. Gokal, N. Dhanjee, M. Wege, S. Govender, S. Tarr, M. Moodley, M. Balkisson, A. Maharaj, S. Ngcobo, N. Rorke, S. Sikhakhane, M. Khumalo, T. Ramsamy, K. Kabongo, W. Kuhn, R. Matos-Puig, R. Naidoo, A. Thotharam, A. Chohan, S. Adam, I. Appel, A. Burke, C. de Vos, S. Gautam, E. Joubert, R. Rautenbach, D. Roytowski, A. Szpytko, E. Brits, B. Diedericks, G. Naude, J. van Niekerk, Z. Fullerton |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Adolescent Population Infections Cohort Studies 03 medical and health sciences South Africa 0302 clinical medicine Postoperative Complications 030202 anesthesiology Risk Factors Medicine Humans Hospital Mortality Prospective Studies Prospective cohort study education Child education.field_of_study business.industry Mortality rate Incidence (epidemiology) Incidence Infant Newborn Infant Perioperative Length of Stay Clinical trial Anesthesiology and Pain Medicine Treatment Outcome Child Preschool General Surgery Female Outcomes research business Cohort study |
| Zdroj: | British journal of anaesthesia. 122(2) |
| ISSN: | 1471-6771 |
| Popis: | Children comprise a large proportion of the population in sub-Saharan Africa. The burden of paediatric surgical disease exceeds available resources in Africa, potentially increasing morbidity and mortality. There are few prospective paediatric perioperative outcomes studies, especially in low- and middle-income countries (LMICs).We conducted a 14-day multicentre, prospective, observational cohort study of paediatric patients (aged16 yrs) undergoing surgery in 43 government-funded hospitals in South Africa. The primary outcome was the incidence of in-hospital postoperative complications.We recruited 2024 patients at 43 hospitals. The overall incidence of postoperative complications was 9.7% [95% confidence interval (CI): 8.4-11.0]. The most common postoperative complications were infective (7.3%; 95% CI: 6.2-8.4%). In-hospital mortality rate was 1.1% (95% CI: 0.6-1.5), of which nine of the deaths (41%) were in ASA physical status 1 and 2 patients. The preoperative risk factors independently associated with postoperative complications were ASA physcial status, urgency of surgery, severity of surgery, and an infective indication for surgery.The risk factors, frequency, and type of complications after paediatric surgery differ between LMICs and high-income countries. The in-hospital mortality is 10 times greater than in high-income countries. These findings should be used to develop strategies to improve paediatric surgical outcomes in LMICs, and support the need for larger prospective, observational paediatric surgical outcomes research in LMICs.NCT03367832. |
| Databáze: | OpenAIRE |
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