4 research outputs found
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
- Author
- Abantanga FA
- Abatli SJ
- Abbas W
- Abbo O
- Abd Elmenam M
- Abd Razak RB
- Abdelbaqi R
- Abdelhady DS
- Abdelhafez MOM
- Abdelhamid SS
- Abdelmaksoud S
- Abdelmoumen R
- Abdelmutalib F
- Abdul-Mumin A
- Abduljawad FM
- Abdullah F
- Abdulraheem N
- Abdulrahman A
- Abdulsalam MA
- Abdunomonovich DA
- Abib SDCV
- Aboelela A
- Abouheba M
- Abrahamsson K
- Abu Ajwa AE
- Abu Al-saleem HSH
- Abu Alamrain AA
- Abu Bakar AH
- Abu Farha MS
- Abu Jamie N
- Abu Jamie YMK
- Abu Jayyab M
- Abu Mayaleh A
- Abu Shiha E
- Abu Za'nouneh FJ
- Abu-Nejmah F
- Abuajaila A
- Abuattaya AA
- Abubakar AM
- Abueideh A
- Abuhayyeh HA
- Abuhlega MA
- Abukhalaf S
- Abumunshar AA
- Acuna G
- Adams S
- Adamu S
- Adanan MFSBM
- Adawi I
- Adawi S
- Adawy A
- Ade-Ajayi N
- Adegboyega R
- Ademuyiwa A
- Adesanya O
- Adhiwidjaja CF
- Adofo-Ansong N
- Agboola TH
- Agelebe E
- Aguiar AA
- Aguilar FA
- Aguirre-Lopez P
- Agulham MA
- Ahmad H
- Ahmad ZAH
- Ahmed H
- Ahmed MA
- Ajai OT
- Ajao EA
- Ajiboye OS
- Ajrami Y
- Akan ME
- Akhbari M
- Akhter N
- Akova F
- Al Dammagh NM
- Al Hussein S
- Al Massry NA
- Al Quran TM
- Al-Attar HM
- Al-Halbouni L
- Al-Mamun A
- Al-Mayoof AF
- Al-Momani HM
- Al-Mouakeh A
- Al-Rayyes M
- Al-Salhi AA
- Al-Shwaikh SH
- Al-Slaibi I
- Al-Taher RN
- Al-Taher RN
- Al-Tammam H
- Alakaloko F
- Alattas K
- Alberto C
- Albozidi A
- Alcantara E
- Aldirawi MAM
- Alebbini MM
- Alfoghi M
- Algabri HNO
- Alglaib MM
- Alhamid A
- Alhamid A
- Alhassan P
- Ali H
- Ali KO
- Ali L
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- Alijla S
- Alijla SS
- Aliwisat AH
- Aljaboo H
- Aljadidi WOFS
- Aljarad Z
- Alkali YS
- Alkareem RMA
- Almada SA
- Almadhoun W
- Almasri M
- Almeida G
- Almengar I
- Almohamady H
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- Almusleh TFH
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- Alonso V
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- Alqor MOI
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- Alsaggaf A
- Alsaied A
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- Alser OH
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- Zreeg DAS
- Zurikat RO
- Zvizdic N
- Zvizdic Z
- Publication venue
- ELSEVIER SCIENCE INC
- Publication date
- 24/07/2021
- Field of study
Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030
Cross-border movement, economic development and malaria elimination in the Kingdom of Saudi Arabia
- Author
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
Malaria at international borders presents particular challenges with regards to elimination. International borders share common malaria ecologies, yet neighboring countries are often at different stages of the control-to-elimination pathway. Herein, we present a case study on malaria, and its control, at the border between Saudi Arabia and Yemen. Malaria program activity reports, case data, and ancillary information have been assembled from national health information systems, archives, and other related sources. Information was analyzed as a semi-quantitative time series, between 2000 and 2017, to provide a plausibility framework to understand the possible contributions of factors related to control activities, conflict, economic development, migration, and climate. The malaria recession in the Yemeni border regions of Saudi Arabia is a likely consequence of multiple, coincidental factors, including scaled elimination activities, cross-border vector control, periods of low rainfall, and economic development. The temporal alignment of many of these factors suggests that economic development may have changed the receptivity to the extent that it mitigated against surges in vulnerability posed by imported malaria from its endemic neighbor Yemen. In many border areas of the world, malaria is likely to be sustained through a complex congruence of factors, including poverty, conflict, and migration
Pancreatic surgery outcomes: multicentre prospective snapshot study in 67 countries
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- Publication venue
- Publication date
- 18/01/2024
- Field of study
Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study
- Author
- Abada S
- Abbas Syed R
- Abbas JD
- Abdalla M
- Abdel-Khaleq S
- Abdelrahim ASA
- Abdelrazek M
- Abdelrazik Y
- Abdi M
- Abdolrazaghi S
- Abdul-Fattah S
- Abdulla S
- Abdullah M
- Abi Aoun R
- Abid S
- Abigail S
- Abou El Ela Bourquin B
- Abousamra M
- Adabavazeh B
- Adams J
- Adams M
- Adams N
- Adcock A
- Adebambo D
- Adeboyejo O
- Adeeko ES
- Adelekan K
- Adelowo T
- Adeniken E
- Adeoye A
- Adeusi L
- Afsheen N
- Agarwal A
- Agarwal G
- Agarwal N
- Agbinya N
- Aghanenu O
- Agiotakis S
- Aguirrezabala Armbruster B
- Ahari D
- Ahmad Fuad MF
- Ahmad MA
- Ahmad NA
- Ahmadi H
- Ahmed Osman A
- Ahmed A
- Ahmed I
- Ahmed J
- Ahmed M
- Ahmed O
- Ahmed S
- Ahmed SK
- Ahmed W
- Ainsworth J
- Ainsworth K
- Aitken S
- Ajdarpasic D
- Ajekigbe F
- Akbar Z
- Akhbari M
- Akintunde A
- Akinyemi J
- Akmal A
- Akmal K
- Akram B
- Al Bahri T
- Al Bakry M
- Al Dabbagh A
- Al Rawi M
- Al Sadek Y
- Al-Hamid Z
- Al-Khafaji M
- Alam F
- Alattas A
- Alawattegama LH
- Alberts J
- Alfadhel S
- Alhwaishel K
- Ali Butt S
- Ali A
- Ali K
- Ali M
- Ali N
- Ali S
- Alim L
- Alkandari B
- Alkoot M
- Allan D
- Allan J
- Allen K
- Allen R
- Allin D
- Almoosawy SA
- Alom J
- Alsaady A
- Alsadoun L
- Alsusa H
- Alves do Canto Brum H
- Alves D
- Aly R
- Alyacoubi S
- Amakye NY
- Amarnath T
- Amin A
- Amin M
- Amini B
- Anandampillai R
- Anarfi S
- Anderson E
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- Anthony Wilkinson J
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- Kaminskaite V
- Kamran Siddiqui Z
- Kan CYP
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- Kanani A
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- Kankam HK
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- Shaik Mohamed SA
- Shaikh Yousef M
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- Shammoon Y
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- Shandramohan A
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- Sheehan M
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- Shehata Z
- Shehzad MU
- Sheikh A
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- Sodeinde S
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- Sohail B
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- Spence H
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- Stubley T
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- Subramaniam E
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- Suchy H
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- Sugden K
- Sugrue M
- Sujith J
- Suresh G
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- Tadross D
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- Tan EP
- Tan GJS
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- Tan I
- Tan JY
- Tan KE
- Tan LL
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- Tan WWL
- Tan WYR
- Tandle S
- Tang HT
- Tanudisastro M
- Taverner S
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- Thomas-Jones I
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- Tio SW
- Tirimanna R
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- Wenlock R
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- Whiteside E
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- Wignall P
- Wijesingha N
- Wijeyendram P
- Wilcha R
- Wilde S
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- Wilkins E
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- Wilkinson B
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- Williams CYK
- Williams G
- Williams H
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- Wilson C
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- Wilson M
- Wingfield L
- Winterton R
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- Wong E
- Wong KHF
- Wong RH
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- Woodmass M
- Woodward S
- Woon S
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- Wu M
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- Wyn-Griffiths F
- Xu S
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- Yao PC
- Yao SL
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- Yates J
- Yau S
- Ye TTS
- Yeshitila N
- Yin L
- Yip S
- Yoong A
- Yordi S
- Young L
- Young T
- Youssef H
- Yow L
- Yu C
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- Yuen ECT
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- Zahid M
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- Zakieh O
- Zalmay P
- Zaman M
- Zaman S
- Zander A
- Zeicu C
- Zeng G
- Zhang G
- Zhang M
- Zhang N
- Zhao S
- Zhao Z
- Zhu L
- Zilber E
- Zimmerman M
- Zuhairy S
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/06/2022
- Field of study
Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society