Perioperative Mortality Rates as a Health Metric for Acute Abdominal Surgery in Low- and Middle-Income Countries: A Systematic Review and Future Recommendations
Autor: | Tiffany Paradis, Tarek Razek, Gabriel Ndayisaba, Andrew Beckett, John G. Meara, Evan G. Wong, Tongmeesee Somprasong, Marie Rachelle Felizaire, Ipshita Prakash, Paola Fata, Kosar Khwaja, Jeremy Grushka, Dan L. Deckelbaum, Walter D. Johnson, Prem Yohannan |
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Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Scopus Vital signs MEDLINE Health Services Accessibility 03 medical and health sciences Postoperative Complications 0302 clinical medicine Global health medicine Humans Anesthesia Intraoperative Complications Perioperative Period Quality Indicators Health Care Abdomen Acute business.industry Mortality rate Perioperative Length of Stay Surgical Procedures Operative 030220 oncology & carcinogenesis Emergency medicine Income 030211 gastroenterology & hepatology Surgery Metric (unit) business Abdominal surgery |
Zdroj: | World Journal of Surgery. 43:1880-1889 |
ISSN: | 1432-2323 0364-2313 |
Popis: | Approximately 5 billion people do not have access to safe, timely, and affordable surgical and anesthesia care, with this number disproportionately affecting those from low–middle-income countries (LMICs). Perioperative mortality rates (POMRs) have been identified by the World Health Organization as a potential health metric to monitor quality of surgical care provided. The purpose of this systematic review was to evaluate published reports of POMR and suggest recommendations for its appropriate use as a health metric. The protocol was registered a priori with PROSPERO. A peer-reviewed search strategy was developed adhering with the PRISMA guidelines. Relevant articles were identified through Medline, Embase, CENTRAL, CDSR, LILACS, PubMed, BIOSIS, Global Health, Africa-Wide Information, Scopus, and Web of Science databases. Two independent reviewers performed a primary screening analysis based on titles and abstracts, followed by a full-text screen. Studies describing POMRs of adult emergency abdominal surgeries in LMICs were included. A total of 7787 articles were screened of which 7466 were excluded based on title and abstract. Three hundred and twenty-one articles entered full-text screen of which 70 articles met the inclusion criteria. Variables including timing of POMR reporting, intraoperative mortality, length of hospital stay, complication rates, and disease severity score were collected. Complication rates were reported in 83% of studies and postoperative stay in 46% of studies. 40% of papers did not report the specific timing of POMR collection. 7% of papers reported on intraoperative death. Additionally, 46% of papers used a POMR timing specific to the duration of their study. Vital signs were discussed in 24% of articles, with disease severity score only mentioned in 20% of studies. POMR is an important health metric for quantifications of quality of care of surgical systems. Further validation and standardization are necessary to effectively use this health metric. |
Databáze: | OpenAIRE |
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