9 research outputs found
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
- Author
- Aamir Faiqa Binte
- Aamir Syed Roohan
- Ababneh Adnan
- Abbal Muhammad Anas
- Abbas Ahmed M
- Abbas Mostafa
- Abd-Albain Montasir A
- Abdalei Abdulwahab
- Abdalla Ahmed
- Abdalla Ahmed Yassir
- Abdalla Mohamed Galal Ali
- Abdalla Zainab
- Abdallah Mohamed M
- Abdalmahmoud Noon Ezzeldien
- Abdalsadeg Rowa
- Abdelaal Ahmed M
- Abdelbagi Alnazeer Y
- Abdelbaky Mostafa
- Abdelbaset Doaa
- AbdElbaset Esraa
- Abdelbast Menhag
- Abdelfatah Mohammed Abdelnasser
- Abdelgawad Samia
- Abdelhamid Mohamed M
- Abdeljaber Mahmoud
- Abdelkhalig Mubarak
- Abdelmaksoud Mohamed
- Abdelmeguid Rana
- Abdelmelek Dhia Errahmane
- Abdelnaeam Samah
- Abdelnasser Mohammad K
- Abdelrahim Najwa
- Abdelrahman Amira
- Abdelrahman Ayman
- Abdelsalam Hebatalla
- Abdelsamed Enas Abdelbaset
- Abdelwahab Khaled
- Abdoun Meriem
- Abdulali Fatima
- Abdulaziz Mohamed
- Abdulla Dheba Almukhtar
- Abdullah Bahiyah
- Abdullah Bahiyah
- Abdullah Walaa
- Abdullahi Habiba Ibrahim
- Abdulrahman Ahmed
- Abdulrasheed Lubabatu
- Abdulwahed Eman
- Abdulwahed Eman
- Abeysirigunawardana Dewmi
- Abidin Muhammad Fihmi Zainal
- Abiola Olukayode
- Abiyere Henry
- Abodina Ahmed Mohammed
- Aboelela Reham
- AboElfarh Hadeer Elsaeed
- Aboudlal Husein
- AbouHiekal Osama
- Aboulfotouh Ahmed
- Abozid Anwaar
- Abubaker Noora
- Abubaker Noora
- Abufanas Asma
- Abughanima Mahmoud
- Abuhashem Shehab
- Abulafia Daniel
- Abushaala Fatima
- Abushanab Khaled
- AbuShawareb Issa
- Abuuqteish Hamza
- Abuzaho Amany
- Achem Arome
- Adam Eithar
- Adam Mohammed
- Adam Mohammed A
- Addalla Mohamed
- Addley Jordan
- Adeleye Gbadebo
- Adeniyi Adebayo
- Adewole Nathaniel
- Adeyemo Olabisi
- Adeyeye Ademola
- Adeyeye Ademola
- Adly Michael
- Adnan Siti Nasyirah Nisya
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adze Joel Amwe
- Afeikhena Ehis
- Agida Teddy
- Agilla Hamza
- Agnew Emilie
- Agu Joy Onyekachi
- Ahmad Zatul Akmar
- Ahmed Abdalla
- Ahmed Ahmed
- Ahmed Ahmed
- Ahmed Alaaaldeen
- Ahmed Entisar
- Ahmed Habeeba
- Ahmed Hatem
- Ahmed Reem
- Ahmed Rehab
- Ahmed Rihab
- Ahmed Rogia Ahmed Abdalla
- Ahmed Ruaa
- Ahmed Sharwany
- Ahmed Uzair
- Ahmed Wahiba
- Ahmeed Sultan
- Airede Lydia Regina
- Aitchison Lori
- Ajredini Mirac
- Ajulo Adeshina A
- Akaba Godwin
- Akasha Mazin
- Akbar Maha Ghulam
- Akbuz Seyma Orcan
- Akdere Hakan
- Akın Bilge
- Akkaya Ege Nur
- Akpamgbo Chukwunonso Nnamdi
- Akwaisah Ayoub
- Al Hammoud Amr
- Al Rawashdeh Toka
- Al-Baw Mahmoud
- Al-Dahdouh Mosheer
- Al-Haek Safa’
- Al-Hazaimeh Mo'ath
- Al-issawi Dima
- Al-Issawi Subhi
- Al-jammal Maryam
- Al-Juaifari Maytham A
- Al-Mwajeh Tesneem
- Al-Omary Sohaib
- Al-Quossi Mohammed
- Al-Shambaty Yasir Babkir Ali
- Al-Shami Qotadah
- Al-Smirat Heba
- Al-Tahayneh Sief-Addeen
- Al-Touny Aiman
- Al-Touny Shimaa
- Al-zawaydeh Alia
- Alaa Ali
- Alabed Ebtihal
- Alagelli Fatma
- Alagoz Ahmet Can
- Alameen Hind
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- Alaqoubi Retaj
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- Alariby Fatima
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- Alathameen Nassar
- Albakosh Bashir Abobaker
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- Albarhomy Osama
- Albarki Aisha
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- Alboon Mosab
- Alboridy Muneera
- Alboueishi Asraa Ali
- Aldeges Marwan
- Aldreawi Mohammed
- Alflite Asil Omar Saleh
- Alfrijat Tamam
- Alfrjani Tariq
- Algabbasi Salima
- Algatanesh Nassib
- Alhadad Qamrah
- Alhaddad Hoda Salem
- Alhaleem Ayah
- Alhaleeq Saif
- Alharam Abtisam
- Alhashimi Abdulhadi Mohammed Alhadi
- Alhassan Monzer
- Alhudhairy Sara
- Ali Ahmed
- Ali Aml
- Ali Doua
- Ali Eithar M
- Ali Iqra Fatima Munawar
- Ali Maab
- Ali Manal
- Ali Muhammad
- Ali Radwa
- Ali Rawan Alsheikh
- Ali Rzan Ali Hamedelneel
- Ali Shehroz
- Aliosin Oleg
- Aljamal Mohammad
- Aljamal Sarah
- Alkaraja Layth
- Alkaseek Akram
- Alkazali Mustafa
- Alkchr Hayat Ben Hasan Mohamed A A
- Alkhatib Abed Alazeez
- Allam Shereen
- Almahroush Marin
- Almakki Doha Mohammed Ahmed
- Alnajjar Lara
- Alnajjar Majjd
- Alnatsheh Wesam
- Alnour Ammar
- Alomar Rabiaa
- Alomari Yazan
- Alqaarh Aya
- Alragig Zahra
- Alrifae Ghaliya Mohamed H
- Alrosan Risan
- Alsagoff Sharifah Nor Amirah Syed Abdul Latiff
- Alsaid Hamza
- Alsaify Esmat
- Alsaih Sawsan
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- Alshawadfy Abdelrhman
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- Alsheik Ahmad
- Alsori Mohamed
- Alsoudani Ali
- Altabbaa Hashem
- Altahir Mohamed
- Altair Mawadda
- Altaweel Ahmad
- Altughar Bushra
- Alvarez Matias
- Alvarez-Lozada Luis Adrian
- Alvarez-Lozada Luis Adrian
- Alwahaib Anas
- Alwash Mohammed
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- Alzarouq Ebtisam
- Alzarroug Amal
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- Amarasekara Mishka
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- Ametov Amet
- Amin Mostafa K
- Aminu Bashiru
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- Zargar Kamran
- Zarzour Mohamed A
- Zeng Raymond
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- Zhang Caitlin
- Zhang Edward
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- Zhang Yichi
- Zhao Hailin
- Zheng Helen
- Zhou Karen
- Zhou Yida
- Ziergiebel Felix
- Zou Peishan
- Zuylekom Kate Van
- Zuylekom Katie Van
- Zwain Yasir Adnan
- Zyul'korneeva Sof'ya
- Aladna Abdallah
- Aljoumaa Abdullah
- Nawfal Hamdi
- Niazi Ammar
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
Recommended from our members
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Ababneh Hazim S
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbasgholizadeh Rouzbeh
- Abbasi-Kangevari Mohsen
- Abbasian Mohammadreza
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdelwahab Ahmed
- Abdollahi Mohammad
- Abdollahifar Mohammad-Amin
- Abdoun Meriem
- Abdulah Deldar Morad
- Abdullahi Auwal
- Abebe Mesfin
- Abebe Samrawit Shawel
- Abedi Aidin
- Abegaz Kedir Hussein
- Abhilash E S
- Abidi Hassan
- Abiodun Olumide
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abolmaali Meysam
- Abouzid Mohamed
- Aboye Girma Beressa
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abtahi Dariush
- Abu Rumeileh Samir
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abu-Zaid Ahmed
- Abualruz Hasan
- Abubakar Bilyaminu
- Aburuz Salahdein
- Accrombessi Manfred Mario Kokou
- Adal Tadele Girum
- Adamu Abdu A
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adebiyi Akindele Olupelumi
- Adekanmbi Victor
- Adepoju Abiola Victor
- Adetunji Charles Oluwaseun
- Adetunji Juliana Bunmi
- Adeyeoluwa Temitayo Esther
- Adeyinka Daniel Adedayo
- Adeyomoye Olorunsola Israel
- Admass Biruk Adie Adie
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afolabi Aanuoluwapo Adeyimika
- Afzal Muhammad Sohail
- Afzal Saira
- Agampodi Suneth Buddhika
- Agasthi Pradyumna
- Aggarwal Manik
- Aghamiri Shahin
- Agide Feleke Doyore
- Agodi Antonella
- Agrawal Anurag
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Muayyad M
- Ahmad Sajjad
- Ahmad Shahzaib
- Ahmad Tauseef
- Ahmadi Keivan
- Ahmadzade Amir Mahmoud
- Ahmed Ali
- Ahmed Ayman
- Ahmed Haroon
- Ahmed Luai A
- Ahmed Mehrunnisha Sharif
- Ahmed Meqdad Saleh
- Ahmed Muktar Beshir
- Ahmed Syed Anees
- Ajami Marjan
- Aji Budi
- Akara Essona Matatom
- Akbarialiabad Hossein
- Akinosoglou Karolina
- Akinyemiju Tomi
- Akkaif Mohammed Ahmed
- Akyirem Samuel
- Al Hamad Hanadi
- Al Hasan Syed Mahfuz
- Al-Aly Ziyad
- Al-amer Rasmieh Mustafa
- Al-Azzam Sayer
- Al-Gheethi Adel Ali Saeed
- Al-Hanawi Mohammed Khaled
- Al-Marwani Sabah
- Al-Maweri Sadeq Ali Ali
- Al-Mekhlafi Hesham M
- Al-Omari Basem
- Al-Sabah Salman Khalifah
- Al-Tawfiq Jaffar A
- Al-Worafi Yaser Mohammed
- Alahdab Fares
- Alalalmeh Samer O
- Alalwan Tariq A
- Alam Khurshid
- Alam Manjurul
- Alam Noore
- Alanezi Fahad Mashhour
- Alanzi Turki M
- Albakri Almaza
- Albashtawy Mohammed
- AlBataineh Mohammad T
- Alcalde-Rabanal Jacqueline Elizabeth
- Aldawsari Khalifah A
- Aldhaleei Wafa A
- Aldridge Robert W
- Alema Haileselasie Berhane
- Alemayohu Mulubirhan Assefa
- Alemi Sharifullah
- Alemu Yihun Mulugeta
- Alhabib Khalid F
- Alhalaiqa Fadwa Alhalaiqa Naji
- Ali Abid
- Ali Amjad
- Ali Liaqat
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- You Yuyi
- Younis Mustafa Z
- Yousefi Zabihollah
- Yu Chuanhua
- Yu Yong
- Yuh Faith H
- Zadey Siddhesh
- Zadnik Vesna
- Zafari Nima
- Zakham Fathiah
- Zaki Nazar
- Zaman Sojib Bin
- Zamora Nelson
- Zand Ramin
- Zangiabadian Moein
- Zar Heather J
- Zare Iman
- Zarrintan Armin
- Zeariya Mohammed G M
- Zeinali Zahra
- Zhang Haijun
- Zhang Jianrong
- Zhang Jingya
- Zhang Liqun
- Zhang Yunquan
- Zhang Zhi-Jiang
- Zhao Hanqing
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Lei
- Ziafati Makan
- Zielińska Magdalena
- Zitoun Osama A
- Zoladl Mohammad
- Zou Zhiyong
- Zuhlke Liesl J
- Zumla Alimuddin
- Zweck Elric
- Zyoud Samer H
- Ärnlöv Johan
- Šekerija Mario
- Publication venue
- Elsevier
- Publication date
- 01/01/2024
- Field of study
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli