4 research outputs found
Organization Performance Influenced by the BSD and Consultative Management Style
- Publication venue
- 'AMH International Conferences and Seminars Organizing LLC'
- Publication date
- 15/10/2011
- Field of study
The purpose of this study is to investigate the relationship among Balanced Scorecard, consultative management style, participative management style and organization size with organizational performance. All the variables are highly correlated with each other. This is an empirical study and data is collected from 100 respondents of service sector from Azad Kashmir. We used five likert scales to collect data from the respondents and data analyzed through SPSS. The result showed that there is a significant positive correlation among variables. This study also indicates that effective management style is necessary for improving the performance of organization. The result indicates that Balanced Scorecard has significant impact on performance of organization. Organization use BSC to handle the complexity and challenges that management faces during their operations. The collection of data is from small area due to time constraint. In the future comparative study can be done with other organizations for better analysis of results
Impact of CSR, Quality of Work Life and Organizational Structure on Employee’s Performance in Pakistan
- Publication venue
- 'AMH International Conferences and Seminars Organizing LLC'
- Publication date
- 15/08/2011
- Field of study
The trends of organizations are changing and demanding satisfied employees rather than dissatisfied employees. This paper provides factors through which employee’s performance can be increased to achieve organizational goals and objectives. To attract the motivated employees and building relations, CSR can perform for society which will change the thoughts of stakeholders. Quality of work life has impact on organization’s effectiveness which is essential for firms to be healthy and productive. Firms should adopt employee oriented policies which satisfies them to achieve organizational objectives. This study also indicates that effective organizational structure is necessary for improving the performance of employees and the organization. The structure is a source of success or failure because it empowers the employee which will increase the sense of responsibility. For the improvement in the organization and removing stress of the employees management must consider the hygiene factors to motivate the employees. The conceptualized work is conducted which is proved through evidence. For further study statistical analysis can be done for confirmation of the hypothesis
Observation of gravitational waves from the coalescence of a 2.5−4.5 M⊙ compact object and a neutron star
- Author
- Abac Adrian
- Abbott R.
- Abouelfettouh I.
- Acernese F.
- Ackley Kendall
- Adhicary S.
- Adhikari Naresh
- Adhikari Rana X.
- Adkins V. K.
- Afif Ismail M.
- Agarwal Deepali
- Agathos Michalis
- Aghaei Abchouyeh Maryam
- Aguiar Odylio D.
- Aguilar I.
- Aiello Lorenzo
- Ain Anirban
- Ajith Parameswaran
- Akcay Sarp
- Akseli Hannuksela Otto
- Akutsu Tomotada
- Al-Jodah Ammar
- Al-Shammari S.
- Albanesi Simone
- Alex iandolo Guido
- Alfaidi Reem Atallah E
- Allocca Annalisa
- Alléné C.
- Altin Paul
- Alvarez-Lopez Sofia
- Amato Alex
- Amez-Droz L.
- Amorosi A.
- Amra C.
- Ananyeva A.
- Anderson Stuart
- Anderson Warren G.
- Andia Manuel
- Ando M.
- Andrade T.
- Andrea Prodi Giovanni
- Andres Nicolas
- Andric Tomislav
- Andrés Vallejo Peña Sergio
- Andrés-Carcasona Marc
- Anglin J.
- Anne Bizouard Marie
- Ansoldi Stefano
- Antelis Javier M.
- Antier Sarah
- Antoni Ramis Vidal Felip
- Antonietta Palaia Maria
- Antonio Font Roda Jose
- Aoumi M.
- Appavuravther E. Z.
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- Arai Koji
- Araya Akito
- Araya Melody
- Areeda Joseph
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- Arif Shaikh Md
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- Arnaud Nicolas
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- Aronson Scott
- Arun K. G.
- Ashton Gregory
- Aso Yoichi
- Assiduo M.
- Aston S. M.
- Astone Pia
- Attadio Francesca
- Aubin Florian
- AVALLONE Guerino
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- Yamamura S.
- Yamazaki Ryo
- Yan S.
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- Yarbrough Zach
- Yasui H.
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- Yelikar A. B.
- Yin X.
- Yokoyama Jun'ichi
- Yokozawa T.
- Yoo Jooheon
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- Zhao Yuhang
- Zheng Yanyan
- Zhong Haowen
- Zhou R.
- Zhu Xingjiang
- Zhu Zong-Hong
- Zimmerman Aaron
- Zucker M. E.
- Zweizig John
- Árpád Gergely László
- 劉 國欽
- 都丸 隆行
- Publication venue
- Publication date
- 23/04/2024
- Field of study
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
- Author
- Ç
- Ö
- Ž
- Ž
- Ž
- &apos
- Aahlin Ek
- Aamer A
- Aaniana K
- Ababneh A
- Abaliksta T
- Abantanga F
- Abantanga F
- Abbas A
- Abbas M
- Abbasy J
- Abbo O
- Abbo O
- Abbott T
- Abbouch M
- Abd-Elmawla M
- Abd-Elrasoul Y
- Abdallah E
- Abdallah E
- Abdel-Aty A
- Abdel-Hameed N
- Abdel-Kader Sm
- Abdel-Wahab Nye
- Abdelaal A
- Abdelaty M
- Abdelazeam Ar
- Abdelazim G
- Abdelaziz Ma
- Abdelbadeai K
- Abdelfatah A
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelhady S
- Abdelhamed R
- Abdelhamid A
- Abdelhaq A
- Abdelkader M
- Abdelkader M
- Abdelkader O
- Abdelkareem A
- Abdelkhalek M
- Abdelmageed E
- Abdelmotaleb I
- Abdelraheim M
- Abdelraouf Am
- Abdelrouf Dm
- Abdelshafy M
- Abdelshakour M
- Abdrabou Ak
- Abdul-Latif S
- Abdulaziz H
- Abdulaziz M
- Abdulbagi O
- Abdulgawad M
- Abdulhakeem Em
- Abdullah Ma
- Abdullah N
- Abdullah Nan
- Abdullah Nan
- Abdullahi L
- Abdurrazzaaq A
- Abebe Ns
- Abebe Ns
- Abem Oe
- Aber A
- Abington E
- Abiola O
- Aboarab A
- Aboelella M
- Aboelmagd O
- Aboelsoud Mr
- Aboraya M
- Aboraya M
- Abouelnasr A
- Aboul-Naga Ms
- Abouzahra A
- Abouzaid A
- Abozaid M
- Abozeid K
- Abozyed Maf
- Abu-Toyour M
- Abubakr M
- Abudeeb H
- Abuowda Y
- Abuqwaider E
- Abusalem L
- Abuseif M
- Abushamleh S
- Acharya P
- Ackom E
- Acquah E
- Adı
- Adam A
- Adam N
- Adams R
- Adamu A
- Adawi I
- Adawi M
- Adebanjo A
- Adebanjo A
- Adebola O
- Adedeji A
- Adekoya A
- Adel A
- Adel A
- Adel Be
- Adel I
- Adella Fj
- Adelshone A
- Ademuyiwa A
- Ademuyiwa A
- Ademuyiwa Ao
- Ademuyiwa Ao
- Ademuyiwa Ao
- Adenekan B
- Adeniran J
- Adeniran J
- Adeniyi A
- Adeniyi A
- Adesanya O
- Adesanya O
- Adesina A
- Adesina A
- Adesuyi A
- Adeyeye A
- Adeyeye A
- Adeyeye A
- Adham W
- Adhitama N
- Adil M
- Adisa Ao
- Adisa Ao
- Adnan Ab
- Adu-Aryee N
- Afana S
- Afandy A
- Afifi Am
- Afzal M
- Agalianos C
- Agalianos C
- Agarwal A
- Agarwal A
- Agarwal A
- Agbedinu K
- Agius M
- Aglan A
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- Aguilar Wlm
- Aguilar-Jimenez J
- Aguilera M
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- Aguilera Ml
- Aguilera O
- Aguilera-Arevalo Ml
- Ahlonsou G
- Ahlqvist S
- Ahlqvist S
- Ahlqvist S
- Ahmed A
- Ahmed A
- Ahmed A
- Ahmed Ea
- Ahmed H
- Ahmed H
- Ahmed H
- Ahmed Lam
- Ahmed S
- Ahmed S
- Ahmed Sm
- Ahounou Eys
- Aigrain Y
- Ajah J
- Ajai O
- Ajao A
- Ajao Ae
- Ajiboye A
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- Akeel N
- Akhtar M
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- Al Awwad S
- Al Barrawi FE
- Al Bastawis F
- Al Meligy A
- Al Rafati AAR
- Al Raouf EA
- Al Saied G
- Al Subaie N
- Al-Aarag Aa
- Al-Azraqi Iaa
- Al-Bahrani A
- Al-Buhaisi A
- Al-Dakka E
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- Al-Faqawi M
- Al-Farram H
- Al-Hameedi Hii
- Al-Hasani Rkmj
- Al-Khatib A
- Al-Mallah A
- Al-Marakby D
- Al-Mousa M
- Al-Nahrawi S
- Al-Obaedi O
- Al-Saqqa S
- Al-Saqqa Sw
- Al-Shammari A
- Al-Slaibi I
- Al-Taher T
- Alaael-Dein S
- Alada M
- Alahmady O
- Alakaloko F
- Alakaloko F
- Alaloul E
- Alamin S
- Alamoudi M
- Alamoudi U
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- Albiety A
- Aldalaq A
- Aldhafeeri S
- Aledrisy M
- Alexander P
- Alexander P
- Alexandre C
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- Alghamdi A
- Alghamdi B
- Alghamdi M
- Alghamdi Msa
- Algohary O
- Alhabli I
- Alhady K
- Alhammali T
- Alhassan B
- Alhazmi W
- Alhendy M
- Alherz M
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- Ali A
- Ali A
- Ali Cdm
- Ali E
- Ali Fm
- Ali H
- Ali S
- Ali Sawew
- Ali Ss
- Ali Tha
- Ali W
- Alihonou T
- Alimi Q
- Alimi Q
- Alis H
- Aliyu H
- Aliyu M
- Aliyu S
- Aljboor K
- Aljiffry M
- Aljiffry M
- Aljohani E
- Aljohani E
- Aljohani S
- Alkaaki A
- Alkammash A
- Alkelani M
- Alkhabbaz D
- Alkhouri M
- Allam M
- Allam M
- Allam Y
- Allegri A
- Allegri A
- Allen Jly
- Allen-Ingabire Jc
- Allott R
- Almallah A
- Almanon Cl
- Almoflihi A
- Almuallem S
- Almy J
- Alnaby Mh
- Alnawam E
- Alnuqaydan Sa
- Alnusairat A
- Alomar In
- Alqahtani E
- Alqahtani S
- Alrahawy M
- Alrajraji M
- Alrifaie A
- AlRowais M
- Alsaggaf M
- Alsaggaf Mu
- Alsaggaf Mu
- Alser Oh
- Alshareef R
- Altaf A
- Altaf A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamini A
- Altarayra M
- Althwainy A
- Altibi A
- Altinel Y
- Altinel Y
- Altoe F
- Altwigry Am
- Altwijri A
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- Alwafai Mg
- Aly Ak
- Aly Mym
- Alyacoubi S
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- Alyami R
- Alyami R
- AlYoussef I
- Alzahrani M
- Alzahrani M
- Alzahrani Mna
- Alzayat T
- Aman Nf
- Amandito R
- Amandito R
- Amandito R
- Amandito R
- Ambrona-Zafra D
- Ambrozeviciute V
- Ameen M
- Amer Ma
- Amin Haa
- Amin J
- Amin J
- Amjad M
- Ammar M
- Ammar Ms
- Amoah M
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- Amoako-Boateng M
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- Amreia M
- Amreia M
- Anandkumar D
- Anderson D
- Anderson F
- Anderson R
- Anderson-Knight H
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- Andika Ffa
- Andreotti D
- Andress C
- Andriola V
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- Anis E
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- Ansaloni L
- Ansaloni L
- Ansaloni L
- Antar S
- Antezana D
- Anthoulakis C
- Anthoulakis C
- Antoniozzi A
- Anwar Aw
- Anwar N
- Anwer W
- Anyanwu Lj
- Anyanwu Lj
- Aonzo P
- Appeadu-Mensah W
- Appiah Ek
- Aql S
- Aquilino F
- Arachchi Pp
- Arachchige Lajj
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- Arango Mcm
- Araujo Jslr
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- Arnaud Ap
- Arshad Mm
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- Arulampalam T
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- Asaat Ul Razi S
- Asal M
- Asar Yh
- Asare-Bediako K
- Asele Fa
- Ashour A
- Ashour A
- Ashour K
- Ashraf Sf
- Ashtari M
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- Augestad Km
- Aung Kp
- Austraite A
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- Avoka A
- Awad I
- Awad Sa
- Awadallah S
- Awuku-Asabre J
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- Ayandipo O
- Ayandipo Oo
- Aydin Mc
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- Aziz Mra
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- Baky Fahmy MA
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- Barreda Lma
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- Barrios E
- Barrios E
- Barry J
- Basilicò
- Basir Erm
- Bassem M
- Bassit Ka
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- Bautista Acm
- Bayram S
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- Bediako-Bowan A
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- Beisa V
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- Bekhet Nm
- Beleñ
- Belkouchi A
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- Benevento A
- Benger M
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- Bermú
- Bernardo Cg
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- Beuran M
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- Bhatnagar A
- Bhattacharya S
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- Bhopal Kf
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- Birring A
- Bisset C
- Bjö
- Bjö
- Blacker S
- Blackwell J
- Blanco R
- Blanco-Colino R
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- Bliksø
- Blower E
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- Boakye-Yiadom K
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- Boddy A
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- Bode C
- Bodur S
- Boereboom C
- Boggon A
- Boijsen M
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- Bonavia K
- Bonavina L
- Bonavina L
- Bond-Smith G
- Bondin J
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- Bondurri A
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- Borda-Luque G
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- Borg E
- Borg E
- Borin E
- Bortolasi L
- Bortolasi L
- Boshnaq M
- Botero Jam
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- Botto N
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- Bougard H
- Boukhal K
- Bowabsak A
- Bowe R
- Bowley D
- Bowling K
- Bowman C
- Boyce T
- Bré
- Bradulskis S
- Bradulskis S
- Bratu M
- Bratu Mr
- Bratu Rm
- Braungart S
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- Bray Ld
- Breistrand M
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- Breslin R
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- Broch A
- Brogden T
- Brown D
- Brown E
- Brown J
- Brown J
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- Bukari M
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- Bustangi N
- Butt Mt
- Cabrera Ccrr
- Cacurri A
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- Cahill R
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- Camacho R
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- Camilleri Gm
- Camilleri-Brennan J
- Camilleri-Brennan J
- Camilleri-Brennan Jf
- Campagnaro T
- Canto Md
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- Carabott K
- Cardozo Jt
- Cardozo Ram
- Careta Mc
- Carlucci M
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- Carneros Vj
- Carpio J
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- Cassar K
- Castillo Vdp
- Castro Mr
- Catani M
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- Caydiid H
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- Chachulski W
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- Chai Fy
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- Chan Z
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- Chang Ky
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- Cheah Aez
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- Chen Ky
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- Chenn R
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- Chin Yr
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- Chiong Jac
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- Chiu S
- Chiu Smy
- Choi J
- Choi P
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- Chong Cl
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- Chong Hy
- Chong Hy
- Choudhry A
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- Chowdhury D
- Chu K
- Chun A
- Chun T
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- Chung S
- Ciccioli E
- Cirocchi R
- Ciubotaru C
- Claire R
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- Clark T
- Clegg-Lampety Jn
- Clegg-Lamptey Jn
- Clement Kd
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- Confalonieri G
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- Connor K
- Contreras E
- Contreras-Vergara Al
- Coomber R
- Coompson Cl
- Corbellini C
- Corbellino M
- Cornick J
- Coronel J
- Correa Jc
- Corro-Diaz S
- Costa C
- Costa-Maia J
- Costa-Maia J
- Costas-Chavarri A
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- Court E
- Cox D
- Cox M
- Coyoy-Gaitan O
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- Dé
- D&apos
- D&apos
- D&apos
- D&apos
- D&apos
- D&apos
- Da Silva LA
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- Dainius E
- Dakubo J
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- Dambrauskas Z
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- Daniyan M
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- Daqeeq A
- Dar M
- Dar W
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- Darwish Ak
- Das A
- Das K
- Das S
- Dasari M
- Dashnyam E
- Dassah V
- Datta U
- Davenport R
- Davies J
- Davies R
- Davor A
- Dawnay G
- Dawood K
- Dawoud H
- Dayie M
- De Boni D
- De Bono P
- De Bono P
- De Castro Segundo LCB
- De Franciscis S
- De Freitas AVC
- De La Medina AR
- de Leó
- De Leon MZP
- De Leon MZP
- de Lima CVB
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- Debrah S
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- Dedekind B
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- Deichsel F
- Del Basso C
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- Delforge X
- Delgado Jm
- Delgado Msftl
- Dell A
- Dempster E
- Denewar A
- Depalma N
- Deputy M
- Der Y
- Dervenis C
- Despotidis V
- Desta S
- Deutschmann P
- Devadasar Gh
- Dharamshi Ha
- Dhillon D
- Di Franco F
- Di Martino N
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- Di Saverio S
- Diab A
- Diaconescu B
- Diaconescu Ib
- Dias S
- Diaz-Jover P
- Diaz-Zorrilla C
- Dick L
- Dickfos M
- Dickson L
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- Din F
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- Dindyal S
- Dissanayake T
- Djivoh F
- Domini E
- Domini E
- Donnelly P
- Donoghue D
- Dorani Rmnr
- Dorismé
- Dos Santos DV
- Dossou F
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- Doughty J
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- Drake Tm
- Drake Tm
- Driscoll A
- Drungilas M
- Du Plessis D
- du Plooy F
- Du Toit F
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- Dubois A
- Dueñ
- Duffy L
- Duhoranenayo D
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- Dulskas A
- Durand Sya
- Dwydar A
- Ebdewi H
- Ebidy M
- Ebidy Mm
- Ebrahim Os
- Eduard P
- Edwards J
- Edye M
- Eid Mm
- Eisner L
- Ekow M
- El Ashal G
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- El Deen KN
- El Galeel AA
- El Gendy NH
- El Gendy A
- El Halawany M
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- El Jamassi A
- El Kashash A
- El Kholy A
- El Magd AA
- El Mesery S
- El Salam YA
- El Sayed GS
- El Sayed IM
- El Shoura Y
- El Slam MA
- El-Badawy Ha
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- El-Dien Ks
- El-Din Ra
- El-Din Sa
- El-Gizawy E
- El-Hamouly As
- El-Kashef H
- El-Latif Nka
- El-Ma&apos
- El-Rabaa S
- El-Sagheer N
- El-Salam Fa
- El-Sawy A
- El-Sehily A
- El-Shahat Ns
- El-Sheemy H
- El-Taher E
- Elabdin Hz
- Elashmawy M
- Elashry R
- Elazab A
- Elazayem Aa
- Elazoul M
- Elbanby E
- Elbanby Es
- Elbatahgy A
- Elbe P
- Elbermawy M
- Elbisomy Kh
- Eldafrawy M
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- Eldeeb Az
- Eldeen Ea
- Eldin Mab
- Elebute O
- Elebute O
- Elena G
- Elfarargy A
- Elfeki H
- Elfeki H
- Elfiky M
- Elfil M
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- Elfouly N
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- Elfouly Y
- Elgebaly A
- Elgendy Ah
- Elgendy Fi
- Elgheriany M
- Elhadad A
- Elhadary Nm
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- Elhamouly S
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- Elhendawy A
- Elhendawy Aoa
- Elhoseny G
- Elhusseiny Aae
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
- Elkelany A
- Elkhadrawi M
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- Elkholy A
- Elkholy Ss
- Elkolaly Ss
- Elkorashy Am
- Ellison Q
- Elmashala A
- Elmasry M
- Elmelegy R
- Elmihy S
- Elnagar A
- Elnajjar Ma
- Elnemr Ae
- Elrasoul Ya
- Elrazek Aa
- Elsabbagh N
- Elsameea Aa
- Elsawahly Dme
- Elsawy A
- Elsayed M
- Elsayed M
- Elsayed N
- Elsayed Nar
- Elsayed Zm
- Elsebaaye Ao
- Elsehimy M
- Elsemelawy R
- Elshaar M
- Elshaer K
- Elshaer M
- Elshaer M
- Elshafay Ae
- Elshami M
- Elshanwany S
- Elsharkawy Aa
- Elsheikh S
- Elsherbiney S
- Elsherbiny As
- Elsherif Fa
- Elshobary M
- Elsiddig M
- Elsobky S
- Elsorogy Deaa
- Elwaey A
- Elwakil H
- Elwan A
- Elwan A
- Elwy E
- Elzahed N
- Elzayat I
- Elzayat M
- Elzayyat I
- Elzowawi F
- Emadeldin D
- Emadeldin H
- Emara E
- Emile S
- Eng C
- English W
- Esam A
- Escobar Eg.
- Espin-Basany E
- Espinoza F
- Espinoza Kt
- Espinoza Kt
- Essam A
- Essam Aa
- Essam M
- Essoun S
- Esteban E
- Estee Mm
- Estupinian S
- Etchill E
- Etchill E
- Etienne S
- Etman M
- Etwire V
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- Evans E
- Eysa A
- Eyssartier E
- Ezzat E
- Ezzat T
- Faboya O
- Faccincani R
- Fadel A
- Fahiem A
- Fahim M
- Fahy C
- Fairfield C
- Fairfield C
- Fairfield C
- Fakher R
- Falaschi F
- Falco N
- Falzon M
- Farag A
- Farag S
- Farah A
- Farahat Mm
- Faraz A
- Fares M
- Farfan Esf
- Farhad M
- Farhan-Alanie Mmh
- Farhangmehr N
- Farinella E
- Farmakis K
- Farooq T
- Farouk Sam
- Farquharson A
- Farrugia A
- Farrugia A
- Faruq A
- Fathy Am
- Fattah Aa
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe Co
- Fergany A
- Fergusson Sj
- Fergusson Sj
- Fergusson Sj
- Fermani C
- Fermani Cg
- Ferná
- Fernandes C
- Fernandez-Bueno F
- Fernandez-Vega L
- Ferousis C
- Ferreira Sak
- Ferrero E
- Fievet L
- Filatau A
- Findlay-Cooper K
- Firdouse M
- Firdouse M
- Firdouse M
- Firwana A
- Fitsum A
- Fitzgerald Je
- Florez Ljg
- Foco M
- Fok Cyj
- Fontana T
- Foo Cc
- Forlin L
- Forno W
- Fouad A
- Fouad D
- Fouad D
- Fourcade L
- Fowler Aj
- Fozard T
- Fozard T
- Frade F
- Fraga Gp
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- Francois P
- Francois-Coridon H
- Francone E
- Freitas Av
- Frey D
- Frisk B
- Fuentes-Rivera L
- Fujii F
- Furqan Mm
- Gü
- Gü
- Gaafar S
- Gaarder T
- Gad A
- Gad Mo
- Gadelkarim M
- Gadhvi V
- Gado A
- Gaiž
- Gaignard E
- Gaignard E
- Gala T
- Gala T
- Galiqi G
- Galleano R
- Gallo G
- Galloway S
- Galvez Cp
- Gamal D
- Gamal E
- Gamal H
- Gamal S
- Gamaly E
- Gamil D
- Gan C
- Gan Yy
- Gani Ma
- Garaycochea O
- Garcí
- Garcí
- Garcí
- Garcia-Florez L
- Garcia-Marin Ja
- Garcia-Perez Jm
- Garland A
- Gash K
- Gash K
- Gash K
- Gastaldi P
- Gasteratos K
- Gaujoux S
- Gavagna L
- Gbessi Dg
- Gemeah M
- Gemenetzis G
- Gemenetzis G
- George R
- Germanos S
- Germanos S
- Gerosa A
- Gerosa A
- Geuoshy A
- Ghaben A
- Ghandora N
- Ghanem A
- Ghanem E
- Ghanem S
- Ghanem S
- Ghannam M
- Gharib A
- Gharib A
- Ghazy Aa
- Gheith A
- Ghetia M
- Ghetia M
- Ghonaim Ma
- Ghoneem M
- Ghoneim O
- Giacci L
- Giardino Fr
- Giavarini L
- Giglio Mc
- Gilbert R
- Gilbert Rw
- Giles J
- Gillespie M
- Gimzewska M
- Giraldo Rsr
- Giuliani S
- Giuliani S
- Giuriato Tf
- Gkiokas G
- Glasbey J
- Glasbey J
- Glasbey Jc
- Glasbey Jc
- Glover Te
- Glover-Addy H
- Glynn M
- Gobin N
- Gobin N
- Goh Cc
- Goh Cc
- Goh W
- Gohar Meam
- Gokani S
- Goldin E
- Golding D
- Gomaa A
- Gomah M
- Gonzalez M
- Gonzalez Sc
- Goodstein M
- Gosling S
- Gosling Sg
- Gouda A
- Gould L
- Gouldthorpe C
- Gouvas N
- Gouws J
- Graffeille V
- Graffieille V
- Gran M
- Grandinetti Pp
- Grant A
- Grasset E
- Grasset E
- Grassi V
- Gratton R
- Gravante G
- Gravante G
- Gray D
- Grech N
- Green N
- Grella Mg
- Gribauskaite J
- Griffiths E
- Griffiths E
- Griffiths M
- Grima T
- Grisin E
- Grizhja B
- Grobler Dc
- Grosos C
- Grossart C
- Guasti Bpsj
- Gudal A
- Gudal A
- Gudal A
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- Guevara R
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- Publication venue
- 'Wiley'
- Publication date
- 27/11/2018
- Field of study
Background
End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection.
Methods
This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model.
Results
In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001).
Conclusion
Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone