60 research outputs found
Diabetes downregulates GLUT1 expression in the retina and its microvessels but not in the cerebral cortex or its microvessels
- Publication venue
- 'American Diabetes Association'
- Publication date
- Field of study
Do's and Don'ts in Primary Aneurysmal Bone Cysts of the Proximal Femur in Children and Adolescents : Retrospective Multicenter EPOS Study of 79 Patients
- Author
- Badr Ismail T.
- Beltrami Giovanni
- Campanacci Domenico A.
- Coppa Valentino
- Dammerer Dietmar
- de Witte Pieter B.
- Doring Kevin
- Fiocco Marta
- Haara Mikko
- Kraus Tanja
- Laitinen Minna K.
- Scheider Philipp
- Soto-Montoya Camilo
- the EPOS Study Group
- Umer Masood
- van de Sande Michiel A. J.
- van der Heijden Lizz
- van Geloven Thomas P. G.
- Publication venue
- Publication date
- 14/09/2022
- Field of study
Background:Aneurysmal bone cysts (ABC) are rare benign cystic bone tumors, generally diagnosed in children and adolescents. Proximal femoral ABCs may require specific treatment strategies because of an increased pathologic fracture risk. As few reports are published on ABCs, specifically for this localization, consensus regarding optimal treatment is lacking. We present a large retrospective study on the treatment of pediatric proximal femoral ABCs. Methods:All eligible pediatric patients with proximal femoral ABC were included, from 11 tertiary referral centers for musculo-skeletal oncology (2000-2021). Patient demographics, diagnostics, treatments, and complications were evaluated. Index procedures were categorized as percutaneous/open procedures and osteosynthesis alone. Primary outcomes were: time until full weight-bearing and failure-free survival. Failure was defined as open procedure after primary surgery, >3 percutaneous procedures, recurrence, and/or fracture. Risk factors for failure were evaluated. Results:Seventy-nine patients with ABC were included [mean age, 10.2 (+/- SD4.0) y, n=56 male]. The median follow-up was 5.1 years (interquartile ranges=2.5 to 8.8).Index procedure was percutaneous procedure (n=22), open procedure (n=35), or osteosynthesis alone (n=22). The median time until full weight-bearing was 13 weeks [95% confidence interval (CI)=7.9-18.1] for open procedures, 9 weeks (95% CI=1.4-16.6) for percutaneous, and 6 weeks (95% CI=4.3-7.7) for osteosynthesis alone (P=0.1). Failure rates were 41%, 43%, and 36%, respectively. Overall, 2 and 5-year failure-free survival was 69.6% (95% CI=59.2-80.0) and 54.5% (95% CI=41.6-67.4), respectively. Risk factors associated with failure were age younger than 10 years [hazard ratios (HR)=2.9, 95% CI=1.4-5.8], cyst volume >55 cm(3) (HR=1.7, 95% CI=0.8-2.5), and fracture at diagnosis (HR=1.4, 95% CI=0.7-3.3). Conclusions:As both open and percutaneous procedures along with osteosynthesis alone seem viable treatment options in this weight-bearing location, optimal treatment for proximal femoral ABCs remains unclear. The aim of the treatment was to achieve local cyst control while minimizing complications and ensuring that children can continue their normal activities as soon as possible. A personalized balance should be maintained between undertreatment, with potentially higher risks of pathologic fractures, prolonged periods of partial weight-bearing, or recurrences, versus overtreatment with large surgical procedures, and associated risks.Peer reviewe
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A.
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O.
- Ademuyiwa Adesoji O.
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O.
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W.
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A.
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Safia
- Ali Syed Abdul Wahhab Eusoffee Wan
- Ali Tebian Hassanein Ahmed
- Ali Wadah
- Alihonou Thierry
- Alis Halil
- Aliyu Halima
- Aliyu Mohammad
- Aliyu Shamsudeen
- Aljboor Khaled
- Aljiffry Murad
- Alkaaki Aroub
- Alkelani Muhammad
- Allam Meran
- Allam Yomna
- Alnaby Mohamed Hassab
- Alnusairat Aseel
- Alqahtani Saleh
- Alsaggaf Mohammed Ubaid
- Alser Osaid H.
- Alshareef Reham
- Altaf Abdulmalik
- Altamimi Abdullah
- Altamimi Afnan
- Altamini Afnan
- Altarayra Marwa
- Altibi Ahmed
- Altinel Yuksel
- Altinel Yuksel
- Altwijri Abdulaziz
- Alvi Abdul Rehman
- Aly Mohammed Yahia Mohamed
- Alyacoubi Said
- Alyahya Reem
- Alzahrani Ahmed
- Aman Nowrin F.
- Amandito Radhian
- Amandito Radhian
- Ambrona-Zafra David
- Amin Hager Abdul Aziz
- Amjad Mohammadasim
- Amoah Michael
- Amoako Joachim
- Amoako Philip Taah
- Amoako-Boateng Mabel
- Amole Isaac
- Amreia Mahmoud
- Anderson Frank
- Andika Ferry Fitriya Ayu
- Andreotti Dario
- Andress Cedar
- Andriola Valeria
- Ang Yun Lin
- Angelieri Daniele
- Anis Echaieb
- Ansaloni Luca
- Ansaloni Luca
- Ansaloni Luca
- Antezana Diego
- Anthoulakis Christos
- Antoniozzi Angelo
- Anwar Nourhan
- Anyanwu Lofty-John
- Aonzo Paolo
- Appeadu-Mensah William
- Appiah Eric Kofi
- Aquilino Fabrizio
- Arafa Omar
- Arafa Sara
- Arango Maria Clara Mendoza
- Arcudi Claudio
- Armellini Andrea
- Arnaud Alexis
- Arnaud Alexis Pierre
- Arshad Mohammad Mohsin
- Arslan Ekin
- Arsyad Hasbi Maulana
- Arthur Tom
- Aruldas Neerav
- Asar Yomna Hosny
- Asare-Bediako Kwasi
- Ashour Ahmad
- Ashour Ahmad
- Ashour Khlood
- Ashtari Morvarid
- Asi Fatema
- Asilah Siti Mohd Desa
- Assal Abdelrahman
- Asturias Sabrina
- Asumah Hamza
- Ata Ahmed
- Ata Aya Yehia
- Atiyeh Anwar
- Atkins Ebenezer Takyi
- Attia Attia
- Augestad Knut Magne
- Aviles Susan
- Avoka Anthony
- Awad Israa
- Awad Sawsan Adel
- Awadallah Salwa
- Ayandipo Omobolaji
- Aydin Mehmet Can
- Aziz Dayang Nita Abdul
- Aziz Mohamed Rezal Abdul
- Aziz Nora Abdul
- Azizeldine Mohammed G.
- Azzie Georges
- Azzis Olivier
- Baba Suleiman
- Bachri Houda
- Badawy Mahmoud
- Badenjki Mohamed Adel
- Badicel Maria
- Badr Mohamed Fawzy Mahrous
- Badwi Nermin Mohamed
- Bahar Suraya
- Baillie Katie
- Baki Bahadir Emre
- Bakr Ahmad
- Bakry Hesham Mohammed
- Bala Miklosh
- Balalis Dimitrios
- Balducci Genoveffa
- Ballouhey Quentin
- Balmaceda Ruben
- Balmaceda Ruben
- Balogun Fatai
- Baltrunas Robertas
- Baluch Fatima
- Bamford Rebecca
- Bamicha Athanasia
- Banaitis Vincas Jonas
- Bandi Ashwath
- Bandoh Dickson
- Bani-Sadar Ahmad
- Banipal Gurpreet Singh
- Baquero Suarez Alibeth Andres
- Baraka Heba
- Barendegere Venerand
- Barkolias Christos
- Barmayehvar Behrad
- Barnabas Gandau Naa
- Barrios Emmanuel
- Basilico Silvia
- Basir Elissa Rifhan Mohd
- Bassem Monica
- Bassit Khalil Abdul
- Basso Stefano M. M.
- Bayram Sefa
- Beamon Mieshia
- Bedada Alemayehu Ginbo
- BediakoBowan Antoinette
- Bekhet Amira Hassan
- Bekhet Nada Mohamed
- Beleno Alvaro Enrique Mendoza
- Belkouchi Abdelkader
- Belli Andrea
- Bello Bashir
- Benammi Sarah
- Benevento Angelo
- Bennai Redouane Mammar
- Bentounsi Zineb
- Benyaiche Chaymae
- Berti Stefano
- Bertuello Isaac
- Beuran Mircea
- Bhangu Aneel
- Bhangu Aneel
- Bhangu Anna
- Bhatnagar Ankur
- Bhopal Kamran Faisal
- Bianco Federica
- Bigaran Annamaria
- Billy Matthew
- Bin Adnan Ahmad
- Bin Hasnan Muhammad
- Bin Ismail Mohamad Jeffrey
- Birindelli Arianna
- Bisset Carly
- Bjorklund Ida
- Blacker Sarah
- Blackwell James
- Blanco Ruth
- Blanco-Colino Ruth
- Blencowe Natalie
- Bliksoen Marte
- Bluelle Rafael
- Bocchetti Tommaso
- Bode Chris
- Bodur Selim
- Boggon Adam
- Bonavia Karl
- Bonavina Luigi
- Bond-Smith Giles
- Bondin John
- Bondurri Andrea
- Boni Silvia
- Bonney William
- Borda-Luque Giuliano
- Borg Elaine
- Borg Elaine
- Bortolasi Luca
- Bottini Corrado
- Bougard Heather
- Boukhal Khaoula
- Bowabsak Alaa
- Bowling Kirk
- Bradulskis Saulius
- Bratu Matei
- Bratu Matei Razvan
- Breaud Jean
- Breistrand Michaela
- Breslin Ryan
- Brincat Svetlana Doris
- Broch Aline
- Brunoni Beatrice
- Bsisu Isam
- Bucci Luigi
- Buisson Philippe
- Bunting David
- Burger Sule
- Burmistrovas Andrius
- Bustangi Nasir
- Bustangi Nasir
- Butt Muhammad Talha
- Cakaloglu Haluk Cem
- Caliman Celeste
- Callan Rory
- Camilleri Georgette Marie
- Camilleri-Brennan Julian
- Campagnaro Tommaso
- Canta Calua Alexander
- Capito Carmen
- Carabott Kurt
- Carmela Lapitan Marie
- Carmona Juan Manuel
- Carpio Juan
- Carrasco Nahilia
- Cassar Kristina
- Catani Marco
- Cautiero Roberto
- Caydiid Hanaan
- Cecilia Tolg
- Celik Saban
- Cengiz Turgut Bora
- Cengiz Yucel
- Cengiz Yucel
- Cevik Muazzez
- Chabok Abbas
- Chai Chu-Ann
- Chai Feng Yih
- Chan Luke
- Chan Tsz-Yan Katie
- Chan Xue Wei
- Charles Angeline
- Cheah Alvin Ee Zhiun
- Chen Kar Yan
- Chen Tzu-Ling
- Cheong Yih Jeng
- Chetta Nicola
- Cheung Yuk Hong Eric
- Chibuye Chali
- Chiesa Deborah
- Chilton Gareth
- Chin Pui Xin
- Chin Ye Ru
- Chiu Seehui
- Choi Philip
- Chong Choon Seng
- Chong Hoong-Yin
- Choudhry Asad
- Chow Crystal Yern Nee
- Chowdhury Debkumar
- Chu Kathryn
- Chung Kuet Jun
- Chungui Bravo Jorge Armando
- Ciccioli Eleonora
- Ciubotaru Cezar
- Claire Raquillet
- Clarissa Audrey
- Clegg-Lampety Joe-Nat
- Clegg-Lamptey Joe-Nat
- Clerico Giuseppe
- Coccolini Federico
- Coccolini Federico
- Cocorullo Gianfranco
- Cohen Fraser
- Cole Simon
- Coletta Diego
- Coletti Massimo
- Collaborative GlobalSurg
- Cona Camilla
- Conci Simone
- Confalonieri Gianmaria
- Conlon Kevin C.
- Connor Katie
- Contreras Elisa
- Coompson Christian Lari
- Corbellini Carlo
- Corbellino Mario
- Cornick Jen
- Coronel Jazmin
- Corral Moreno Sara
- Correa Juan Camilo
- Corro-Diaz Samantha
- Costa Cecilia
- Costa-Maia Jose
- Costas-Chavarri Ainhoa
- Courboin Etienne
- Cox Daniel
- Cox Michael
- Coyoy-Gaitan Otto
- Craus-Miguel Andrea
- Cullen Fraser
- Curletti Gianluca
- Currow Chelise
- D'Amours Scott
- D'Souza Michelle S.
- Dabboor Majd
- Dabbour Kareem
- Dagoe Enoch
- Dahy Ahmed
- Dainius Edvinas
- Dakubo Jonathan
- Dalli Jeffrey
- Dally Charles
- Dambrauskas Zilvinas
- Daniyan Muhammad
- Danys Donatas
- Dao Weihei
- Dar Wasim
- Dardenne Sabrina
- Darwish Abdelrhman K. Z.
- Dasari Mohini
- Dashnyam Enkhbat
- Dassah Victor
- Datta Uttaran
- Davies Rachel
- Davor Anthony
- Dawood Khaled
- Dayie Makafui
- De Boni Davide
- De Franciscis Silvia
- De Luca Emilia
- De Marco Paolino
- Deal Rebecca
- Deane Chelsea
- Debrah Sam
- Dedekind Britta
- Dedey Florence
- Del Basso Celeste
- del Pilar Paucar Arazzelly
- Delforge Xavier
- Dell Angela
- Denakpo Max
- Denewar Adel
- Depalma Norma
- Der Yishan
- Deutschmann Peter
- Dhillon Dharminder
- Di Martino Natale
- Di Saverio Salomone
- Diaconescu Bogdan
- Diaz Vico Tamara
- Diaz Zorrilla Carmina
- Diaz-Jover Paula
- Dick Lachlan
- Dijan Emilio
- Dimech Thea
- Din Farhat
- Dindyal Shiva
- Dione Parreno-Sacdalan Marie
- Dissanayake Tharindra
- Djivoh Fernande
- Domini Edgar
- Donnelly Philippa
- Dorani Radin Mohd Nurrahman Radin
- Dorisme Asnel
- Dossou Francis
- Dousset Bertrand
- Dragatas Deividas
- Drake Thomas M.
- Drake Thomas M.
- Drungilas Mantas
- du Plooy Flip
- Du Toit Frederick
- Duane Therese
- Duinhouwer Lucia
- Dulskas Audrius
- Ebidy Mai
- Ebidy Mai Mohamed
- Eid Mostafa Mahmoud
- El Dahab Ali Abo
- El Gendy Noran Halim
- El Halawany Mohamed
- El Jamassi Alaa
- El Kashash Ahmed
- El Sayed Islam Magdy
- El-Dien Khalid Salah
- El-Din Reham Alaa
- El-Din Shahinaz Alaa
- El-Gizawy Esraa
- El-Sagheer Nada
- El-Sawy Aya
- El-Sehily Ahmed
- El-Taher Esraa
- Elashry Rehab
- Elazab Alaa
- Elbanby Esraa Samir
- Elbe Peter
- Elbisomy Khaled Hesham
- Eldafrawy Mahmoud
- Eldeeb Ahmed Zaki
- Eldeen Esraa Alm
- Eldin Mostafa Ahmed Bahaa
- Elebute Olumide
- Elfarargy Arwa
- Elfeki Hossam
- Elfiky Mahmoud
- Elfouly Nesma
- Elfouly Yasmin
- Elgendy Alyaa Halim
- Elgheriany Mohammed
- Elhadad Alaa
- Elhadary Nourhan Medhat
- Elhadry Shady
- Elhalawany Esraa
- Elhamouly Sara
- Elhelbawy Mohamed Salah
- Elhendawy Abdelaziz
- Elhoseny Ghada
- Elhusseiny Ahmed Abd Elmoen
- Elkholy Shimaa Said
- Ellison Quinn
- Elmashala Amjad
- Elmasry Maha
- Elmihy Sohaila
- Elnagar Ahmedglal
- Elnajjar Mahmoud A.
- Elrazek Aly Abd
- Elsabbagh Nourhan
- Elsameea Ahmed Abd
- Elsawy Amira
- Elsayed Nada Ahmed Reda
- Elsemelawy Rofida
- Elshaar Mohammed
- Elshaer Mohamed
- Elshami Mohamedraed
- Elsharkawy Aya Adel
- Elsherbiney Saged
- Elsherif Fawzia Abdellatif
- Elwy Eman
- Elzahed Nada
- Emadeldin Hossam
- Emara Eman
- Emile Sameh
- Eng Calvin
- English William
- Esam Abeer
- Escalante Salas Marilia Del Carmen
- Espin-Basany Eloy
- Espinoza Fernando
- Essam A. A.
- Essam Ahmed
- Essam Mahitab
- Essoun Samuel
- Esteban Enrique
- Estee Mahnuma Mahfuz
- Etchill Eric
- Etienne Sara
- Etwire Victor
- Evajelista Cicilia Viany
- Evans David
- Evans Elizabeth
- Ezzat Eslam
- Ezzat Tarek
- Faboya Omolara
- Fahim Marwan
- Fairfield Cameron
- Falaschi Federica
- Falco Nicolo
- Falzon Malcolm
- Farag Ahmed
- Farag Sameh
- Farahat Mahitab Morsy
- Fares Mohamed
- Farhan-Alanie Muhamed M. H.
- Farhangmehr Neda
- Farouk Sara Amr Mohamed
- Farrugia Alexia
- Farrugia Alexia
- Faruq Amreen
- Fathy Aya Mohamed
- Fatuga Adedeji
- Faturoti Olubukola
- Favero Alessandro
- Feidantsis Thomas
- Fergany Alaa
- Fergusson Stuart J.
- Fergusson Stuart J.
- Fermani Claudio Gabriel
- Fernandes Cristina
- Fernandez Carmen
- Fernandez-Vega Laura
- Ferousis Christoforos
- Ferrero Esther
- Filatau Aliaksandr
- Firdouse Mohammed
- Firdouse Mohammed
- Firwana Aya
- Fitsum Agazi
- Fitzgerald J. Edward
- Fitzgerald J. Edward
- Florez Farfan Erick Samuel
- Foco Maurizio
- Fok Chi Ying Jacquelyn
- Fontana Tommaso
- Foo Chi Chung
- Forlin Louise
- Fouad Dina
- Fourcade Laurent
- Francisco Roxas Manuel
- Franco Helena
- Francois Poddevin
- Francone Elisa
- Frey Daniel
- Fuentes-Rivera Lorena
- Gaafar Shireen
- Gaarder Tina
- Gad Ahmed
- Gad Mariam O.
- Gadelkarim Mohamed
- Gado Ammar
- Gaizauskas Vytautas
- Gala Tanzeela
- Gala Tanzeela
- Galiqi Gezim
- Galleano Raffaele
- Gallo Gaetano
- Gamal Dina
- Gamal Esraa
- Gamal Heba
- Gamal Shimaa
- Gamil Doaa
- Gan Cheewei
- Gan Yiing Yee
- Gani Mohammed Akil
- Garcia Bernardo Carmen
- Garcia Septiem Javier
- Garcia-Florez Luis
- Gash Katherine
- Gash Katherine
- Gastaldi Pauline
- Gaujoux Sebastien
- Gavagna Laura
- Gbessi Dansou Gaspard
- Gemenetzis Georgios
- Germanos Stylianos
- Gerosa Alexandra
- Geuoshy Abdelrahman
- Ghaben Ahed
- Ghanem Ahmed
- Ghanem Sara
- Ghannam Mohammad
- Ghoneim Omar
- Giardino Francesco Ruben
- Giavarini Luisa
- Giglio Mariano Cesare
- Giraldo Ruben Santiago Restrepo
- Giuliani Stefano
- Gkiokas Georgios
- Glasbey James
- Glasbey James
- Glover-Addy Hope
- Glynn Martha
- Goh Wennweoi
- Goldin Elena
- Gonzales Montejo Maria Soledad
- Gonzalez Mariana
- Gonzalez Mariana
- Gouws Juan
- Gran Mads
- Gravante Gianpiero
- Gray Demi
- Grech Nicole
- Grella Maria Giovanna
- Gribauskaite Jolanta
- Griffiths Ewen
- Grima Tara
- Grisin Edvard
- Grizhja Besmir
- Grobler D. C.
- Grosos Celine
- Gubeli Alissa
- Gudal Ahmad
- Gudal Ahmad
- Guevara Torres Shalon
- Guglielmo Vania
- Gui Daniele
- Gul Enisburak
- Gulbinas Antanas
- Gulcicek Osman Bilgin
- Gulielmi Alfredo
- Gultom Phebe Anggita
- Gunaseelan Kuhaendran
- Gunawan Rudy
- Guner Ali
- Gupta Ashish
- Guzman Duenas Carolina
- Gyamfi Frank Enoch
- Gyedu Adam
- Habeeb Olufemi
- Haddad Nadeem
- Hafez Mohamed
- Hafez Sarah
- Haffreingue Aurore
- Hagan Richmond
- Haines Morgan
- Hajeh Haidar
- Halhouli Oday
- Halhouli Oday
- Halicioglu Ilkay
- Hall Elisabeth
- Haloho Andreass
- Hamarshi Aseel
- Hamasaki Hamaguchi Jose Luis
- Hamdan Ayah
- Hamdan Marwa
- Hamed Mohamed Fouad
- Hamill Daniel
- Hammad Aya
- Hampton Mark Ian
- Hamsho Ward
- Hanoun Sakhaa
- Hantour Usama
- Hany Ethar
- Haque Muhtarima
- Har Prisca A. L.
- Haraux Elodie
- Harrison Ewen M.
- Harrison Ewen M.
- Harrison Ewen M.
- Hartford Leila
- Harvey Neil
- Hasan Ahmad
- Hasan Doaa
- Hasanah Afifatun
- Hasanain Doaa
- Hascoet Juliette
- Hashad Eman
- Hashim Abdullah
- Haslegrave Aidan
- Hassaan Amr
- Hassaan Ayat
- Hassan Ahmed Tarek Abdelbaset
- Hassan Ihab
- Hassan Osama Mokhtar Mohamed
- Hassanain Mazen
- Hassanein Adel B.
- Heard Rachel
- Hegazy Eman Magdy
- Helene Francois-Coridon
- Helguero-Santin Luis M.
- Hemmila Mark
- Heng Hian Ee
- Henric Nicolas
- Henry Fitjerald
- Henshall David Ewart
- Herebat Azher
- Herikstad Ragnar
- Herrera Cruz Danilo
- Herrera Matta Juan Jaime
- Herrod Philip
- Hervieux Erik
- Hesham Omar
- Hilal Karim
- Hjertberg Maria
- Hmila Sophian
- Ho Adrienne
- Hodonou Fred
- Holte Silje
- Homeida Anmar
- Hossameldin Amr
- Hrora Abdelmalek
- Hunter Kristina
- Husseiny Reem
- Iacono Calogero
- Iannone Immacolata
- Ibraheem Aya AbdelFatah
- Ibrahem Ahmad Aboelkassem
- Ibrahim Ahmed Mohamed
- Ibrahim Amal
- Ibrahim Arij
- Ibrahim Arwa
- Ibrahim Eman
- Ibrahim Eman Mohamed
- Ibrahim Khaled
- Ibrahim Mohamed
- Idress Tasneem
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- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T. Ariani
- Widmer Lukas Werner
- Wijayarathna L. S.
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Wilson Michael
- Wimalge P. M. S. N.
- Wogensen Fredrik
- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yap Suhhuey
- Yau Jih Dar
- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- Elsevier
- Publication date
- 01/06/2003
- Field of study
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International CLARIFY registry
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- Publication venue
- 'Public Library of Science (PLoS)'
- Publication date
- 01/01/2015
- Field of study
Global economic burden of unmet surgical need for appendicitis
- Author
- Aahlin E. K.
- Aamer A.
- Aaniana K.
- Ababneh A.
- Abaliksta T.
- Abantanga F.
- Abbas M.
- Abbasy J.
- Abbo O.
- Abbouch M.
- Abd-Elmawla M.
- Abd-Elrasoul Y.
- Abdallah E.
- Abdel-Aty A.
- Abdel-Hameed N.
- Abdel-Kader S. M.
- Abdel-Wahab N. Y. E.
- Abdelaal A.
- Abdelaty M.
- Abdelazeam A. R.
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- Abdelaziz M. A.
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- AbdelFattah I.
- Abdelgelil A.
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- Abdelhady S.
- Abdelhamed R.
- Abdelhamid A.
- Abdelhaq A.
- Abdelkader M.
- Abdelkader O.
- Abdelkareem A.
- Abdelkhalek M.
- Abdelmageed E.
- Abdelmotaleb I.
- Abdelraheim M.
- Abdelraouf A. M.
- Abdelrouf D. M.
- Abdelshafy M.
- Abdelshakour M.
- Abdrabou A. K.
- Abdul-Latif S.
- Abdulaziz H.
- Abdulbagi O.
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- Publication venue
- Oxford University Press
- Publication date
- 01/01/2022
- Field of study
Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
- Author
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
- Aahlin EK
- Aamer A
- Aaniana K
- Ababneh A
- Abaliksta T
- Abantanga F
- Abantanga F
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- Abbasy J
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- Abbouch M
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- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elmawla M
- Abd-Elrasoul Y
- Abdallah E
- Abdallah E
- Abdel-Aty A
- Abdel-Hameed N
- Abdel-Kader SM
- Abdel-Wahab NYE
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- Abdelfatah A
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- Abdelhady S
- Abdelhamed R
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- Aranzabal Durand SY
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- El Shoura Y
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- El-Sagheer N
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- Elazoul M
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- Eldafrawy M
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- Elena G
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- Elfiky M
- Elfil M
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- Elfouly Y
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- Elgendy AH
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- Elgheriany M
- Elhadad A
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- Elhalawany E
- Elhamouly S
- Elhelbawy MS
- Elhendawy A
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- Elhoseny G
- Elhusseiny AAE
- Elizabeth Lopez C
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
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- Elkhadrawi M
- Elkhalek EA
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- Elsherbiny AS
- Elsherif FA
- Elshobary M
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- Elsorogy DEAA
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- Elzahed N
- Elzayat I
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- Elzowawi F
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- Emile S
- Eng C
- English W
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- Escalante Salas MDC
- Espin-Basany E
- Espinoza F
- Essam A
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- Essam M
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- Estupinian S
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- Etienne S
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- Evajelista CV
- Evans D
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- 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
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- Kaafarani H
- Kabariti R
- Kabariti R
- Kabba J
- Kabongo K
- Kache S
- Kaci AA
- Kadiwar S
- Kalakouti E
- Kalles V
- Kalles V
- Kalles V
- Kamarajah SK
- Kamarulzamil SNA
- Kamil R
- Kamya S
- Kanani A
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- Kang MK
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- Karabacak U
- Karabelias G
- Karabulut K
- Karahan SR
- Karakahya M
- Karandikar S
- Karandikar S
- Kariem N
- Karim A
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- Karjiker P
- Karkeet M
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- Karlo R
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- Karousos D
- Karumnas P
- Kaselis N
- Kaselis N
- Kasem E
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- Kasputyte S
- Kaul A
- Kazanavicius D
- Kedar A
- Kefalidi E
- Keke KR
- Kelany M
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- Kennedy ED
- Kennedy M
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- Kerley R
- Kershaw S
- Kesinger M
- Khafagy T
- Khairy H
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- Khajanchi M
- Khaled H
- Khalifah E
- Khalili M
- Khalique A
- Khallaf S
- Khamajeet A
- Khan A
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- Khatri C
- Khatri C
- Khattab K
- Khedr AE-RH
- Khoja A
- Khoja A
- Khokha D
- Khokha V
- Khosla S
- Khouri Ferreira SA
- Khreishi R
- Khreishi R
- Khulu LB
- Khyrallh A
- Kiasat A
- Kidd T
- Kielty P
- Kim MY-H
- Kim S-H
- Kim SB
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- Kinandu K
- King R
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- Kiran RP
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- Klappenbach R
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- Kojo ATT
- Kojo ATT
- Kojo ATT
- Kolosov A
- Komolafe O
- Kondrotas P
- Kong C
- Kong SN
- Kong V
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- Konstantina K
- Kontos M
- Kordorwu HEK
- Korkolis D
- Kosai NR
- Kosai NR
- Kose E
- Koskenvuo L
- Kostov E
- Kotb AHE-B
- Kotecha D
- Koto MZ
- Kotobi H
- Koumpa F
- Kouraklis G
- Kourdouli A
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- Kretzmann H
- Krishna K
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- Kyriazanos I
- Kyrou G
- Kyziridis D
- L'Heveder A
- La Brocca A
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- Labib P
- Ladukas A
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- Lam FY
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- Lam WH
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- Lauzikas G
- Law JH
- Lawal A
- Lawal AO
- Lawal T
- Lawal TA
- Lawani I
- Lawther R
- Lazzari G
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- Lazzarini Cury AD
- Le VTH
- Leal A
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- Lecompte J-F
- Lee C
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- Lee F
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- Leusink A
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- Li KKK
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- Lilford R
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- Lim G
- Lim H
- Lim J
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- Lim SJ
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- Lim SY
- Limache S
- Limaye N
- Limoges B
- Linares Delgado MSDFT
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- Macchitella Y
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- Machaca M
- Machain Vega GM
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- Maciejec L
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- Madrid Barrientos LA
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- Mangan C
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- Manipal CE
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- Mirza A
- Mirza S
- Mistry A
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- Mitroudi M
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- Moe TT
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- Mohamed F
- Mohamed I
- Mohamed M
- Mohamed MA
- Mohamed MAEH
- Mohamed MM
- Mohamed O
- Mohamed SR
- Mohameden A
- Mohammad A
- Mohammad A
- Mohammed A
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- Mohammed MMH
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- Monteleone M
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- Montes I
- Montes I
- Montoya Botero JA
- Montrimaite M
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- Moodley Y
- Moore R
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- Morandi E
- Moreira G
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- Mosalum O
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- Mostafa M
- Mousa M
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- Neophytou C
- Nepogodiev D
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- Nwabuoku E
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- Sahel S
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- Sakr A
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- Samaraweera DI
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- Sammarco G
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- Sandoval Barrantes AM
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- Publication venue
- Publication date
- 15/10/2018
- Field of study
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2022
- Field of study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Ademuyiwa Adesoji O
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Safia
- Ali Syed Abdul Wahhab Eusoffee Wan
- Ali Tebian Hassanein Ahmed
- Ali Wadah
- Alihonou Thierry
- Alis Halil
- Aliyu Halima
- Aliyu Mohammad
- Aliyu Shamsudeen
- Aljboor Khaled
- Aljiffry Murad
- Alkaaki Aroub
- Alkelani Muhammad
- Allam Meran
- Allam Yomna
- Alnaby Mohamed Hassab
- Alnusairat Aseel
- Alqahtani Saleh
- Alsaggaf Mohammed Ubaid
- Alser Osaid H
- Alshareef Reham
- Altaf Abdulmalik
- Altamimi Abdullah
- Altamimi Afnan
- Altamini Afnan
- Altarayra Marwa
- Altibi Ahmed
- Altinel Yuksel
- Altinel Yuksel
- Altwijri Abdulaziz
- Alvi Abdul Rehman
- Aly Mohammed Yahia Mohamed
- Alyacoubi Said
- Alyahya Reem
- Alzahrani Ahmed
- Aman Nowrin F
- Amandito Radhian
- Amandito Radhian
- Ambrona-Zafra David
- Amin Hager Abdul Aziz
- Amjad Mohammadasim
- Amoah Michael
- Amoako Joachim
- Amoako Philip Taah
- Amoako-Boateng Mabel
- Amole Isaac
- Amreia Mahmoud
- Anderson Frank
- Andika Ferry Fitriya Ayu
- Andreotti Dario
- Andress Cedar
- Andriola Valeria
- Ang Yun Lin
- Angelieri Daniele
- Anis Echaieb
- Ansaloni Luca
- Ansaloni Luca
- Ansaloni Luca
- Antezana Diego
- Anthoulakis Christos
- Antoniozzi Angelo
- Anwar Nourhan
- Anyanwu Lofty-John
- Aonzo Paolo
- Appeadu-Mensah William
- Appiah Eric Kofi
- Aquilino Fabrizio
- Arafa Omar
- Arafa Sara
- Arango Maria Clara Mendoza
- Arcudi Claudio
- Armellini Andrea
- Arnaud Alexis
- Arnaud Alexis Pierre
- Arshad Mohammad Mohsin
- Arslan Ekin
- Arsyad Hasbi Maulana
- Arthur Tom
- Aruldas Neerav
- Asar Yomna Hosny
- Asare-Bediako Kwasi
- Ashour Ahmad
- Ashour Ahmad
- Ashour Khlood
- Ashtari Morvarid
- Asi Fatema
- Asilah Siti Mohd Desa
- Assal Abdelrahman
- Asturias Sabrina
- Asumah Hamza
- Ata Ahmed
- Ata Aya Yehia
- Atiyeh Anwar
- Atkins Ebenezer Takyi
- Attia Attia
- Augestad Knut Magne
- Aviles Susan
- Avoka Anthony
- Awad Israa
- Awad Sawsan Adel
- Awadallah Salwa
- Ayandipo Omobolaji
- Aydin Mehmet Can
- Aziz Dayang Nita Abdul
- Aziz Mohamed Rezal Abdul
- Aziz Nora Abdul
- Azizeldine Mohammed G
- Azzie Georges
- Azzis Olivier
- Baba Suleiman
- Bachri Houda
- Badawy Mahmoud
- Badenjki Mohamed Adel
- Badicel Maria
- Badr Mohamed Fawzy Mahrous
- Badwi Nermin Mohamed
- Bahar Suraya
- Baillie Katie
- Baki Bahadir Emre
- Bakr Ahmad
- Bakry Hesham Mohammed
- Bala Miklosh
- Balalis Dimitrios
- Balducci Genoveffa
- Ballouhey Quentin
- Balmaceda Ruben
- Balmaceda Ruben
- Balogun Fatai
- Baltrunas Robertas
- Baluch Fatima
- Bamford Rebecca
- Bamicha Athanasia
- Banaitis Vincas Jonas
- Bandi Ashwath
- Bandoh Dickson
- Bani-Sadar Ahmad
- Banipal Gurpreet Singh
- Baquero Suarez Alibeth Andres
- Baraka Heba
- Barendegere Venerand
- Barkolias Christos
- Barmayehvar Behrad
- Barnabas Gandau Naa
- Barrios Emmanuel
- Basilico Silvia
- Basir Elissa Rifhan Mohd
- Bassem Monica
- Bassit Khalil Abdul
- Basso Stefano MM
- Bayram Sefa
- Beamon Mieshia
- Bedada Alemayehu Ginbo
- BediakoBowan Antoinette
- Bekhet Amira Hassan
- Bekhet Nada Mohamed
- Beleno Alvaro Enrique Mendoza
- Belkouchi Abdelkader
- Belli Andrea
- Bello Bashir
- Benammi Sarah
- Benevento Angelo
- Bennai Redouane Mammar
- Bentounsi Zineb
- Benyaiche Chaymae
- Berti Stefano
- Bertuello Isaac
- Beuran Mircea
- Bhangu Aneel
- Bhangu Aneel
- Bhangu Anna
- Bhatnagar Ankur
- Bhopal Kamran Faisal
- Bianco Federica
- Bigaran Annamaria
- Billy Matthew
- Bin Adnan Ahmad
- Bin Hasnan Muhammad
- Bin Ismail Mohamad Jeffrey
- Birindelli Arianna
- Bisset Carly
- Bjorklund Ida
- Blacker Sarah
- Blackwell James
- Blanco Ruth
- Blanco-Colino Ruth
- Blencowe Natalie
- Bliksoen Marte
- Bluelle Rafael
- Bocchetti Tommaso
- Bode Chris
- Bodur Selim
- Boggon Adam
- Bonavia Karl
- Bonavina Luigi
- Bond-Smith Giles
- Bondin John
- Bondurri Andrea
- Boni Silvia
- Bonney William
- Borda-Luque Giuliano
- Borg Elaine
- Borg Elaine
- Bortolasi Luca
- Bottini Corrado
- Bougard Heather
- Boukhal Khaoula
- Bowabsak Alaa
- Bowling Kirk
- Bradulskis Saulius
- Bratu Matei
- Bratu Matei Razvan
- Breaud Jean
- Breistrand Michaela
- Breslin Ryan
- Brincat Svetlana Doris
- Broch Aline
- Brunoni Beatrice
- Bsisu Isam
- Bucci Luigi
- Buisson Philippe
- Bunting David
- Burger Sule
- Burmistrovas Andrius
- Bustangi Nasir
- Bustangi Nasir
- Butt Muhammad Talha
- Cakaloglu Haluk Cem
- Caliman Celeste
- Callan Rory
- Camilleri Georgette Marie
- Camilleri-Brennan Julian
- Campagnaro Tommaso
- Canta Calua Alexander
- Capito Carmen
- Carabott Kurt
- Carmela Lapitan Marie
- Carmona Juan Manuel
- Carpio Juan
- Carrasco Nahilia
- Cassar Kristina
- Catani Marco
- Cautiero Roberto
- Caydiid Hanaan
- Cecilia Tolg
- Celik Saban
- Cengiz Turgut Bora
- Cengiz Yucel
- Cengiz Yucel
- Cevik Muazzez
- Chabok Abbas
- Chai Chu-Ann
- Chai Feng Yih
- Chan Luke
- Chan Tsz-Yan Katie
- Chan Xue Wei
- Charles Angeline
- Cheah Alvin Ee Zhiun
- Chen Kar Yan
- Chen Tzu-Ling
- Cheong Yih Jeng
- Chetta Nicola
- Cheung Yuk Hong Eric
- Chibuye Chali
- Chiesa Deborah
- Chilton Gareth
- Chin Pui Xin
- Chin Ye Ru
- Chiu Seehui
- Choi Philip
- Chong Choon Seng
- Chong Hoong-Yin
- Choudhry Asad
- Chow Crystal Yern Nee
- Chowdhury Debkumar
- Chu Kathryn
- Chung Kuet Jun
- Chungui Bravo Jorge Armando
- Ciccioli Eleonora
- Ciubotaru Cezar
- Claire Raquillet
- Clarissa Audrey
- Clegg-Lampety Joe-Nat
- Clegg-Lamptey Joe-Nat
- Clerico Giuseppe
- Coccolini Federico
- Coccolini Federico
- Cocorullo Gianfranco
- Cohen Fraser
- Cole Simon
- Coletta Diego
- Coletti Massimo
- Collaborative GlobalSurg
- Cona Camilla
- Conci Simone
- Confalonieri Gianmaria
- Conlon Kevin C
- Connor Katie
- Contreras Elisa
- Coompson Christian Lari
- Corbellini Carlo
- Corbellino Mario
- Cornick Jen
- Coronel Jazmin
- Corral Moreno Sara
- Correa Juan Camilo
- Corro-Diaz Samantha
- Costa Cecilia
- Costa-Maia Jose
- Costas-Chavarri Ainhoa
- Courboin Etienne
- Cox Daniel
- Cox Michael
- Coyoy-Gaitan Otto
- Craus-Miguel Andrea
- Cullen Fraser
- Curletti Gianluca
- Currow Chelise
- D'Amours Scott
- D'Souza Michelle S
- Dabboor Majd
- Dabbour Kareem
- Dagoe Enoch
- Dahy Ahmed
- Dainius Edvinas
- Dakubo Jonathan
- Dalli Jeffrey
- Dally Charles
- Dambrauskas Zilvinas
- Daniyan Muhammad
- Danys Donatas
- Dao Weihei
- Dar Wasim
- Dardenne Sabrina
- Darwish Abdelrhman KZ
- Dasari Mohini
- Dashnyam Enkhbat
- Dassah Victor
- Datta Uttaran
- Davies Rachel
- Davor Anthony
- Dawood Khaled
- Dayie Makafui
- De Boni Davide
- De Franciscis Silvia
- De Luca Emilia
- De Marco Paolino
- Deal Rebecca
- Deane Chelsea
- Debrah Sam
- Dedekind Britta
- Dedey Florence
- Del Basso Celeste
- del Pilar Paucar Arazzelly
- Delforge Xavier
- Dell Angela
- Denakpo Max
- Denewar Adel
- Depalma Norma
- Der Yishan
- Deutschmann Peter
- Dhillon Dharminder
- Di Martino Natale
- Di Saverio Salomone
- Diaconescu Bogdan
- Diaz Vico Tamara
- Diaz Zorrilla Carmina
- Diaz-Jover Paula
- Dick Lachlan
- Dijan Emilio
- Dimech Thea
- Din Farhat
- Dindyal Shiva
- Dione Parreno-Sacdalan Marie
- Dissanayake Tharindra
- Djivoh Fernande
- Domini Edgar
- Donnelly Philippa
- Dorani Radin Mohd Nurrahman Radin
- Dorisme Asnel
- Dossou Francis
- Dousset Bertrand
- Dragatas Deividas
- Drake Thomas M
- Drake Thomas M
- Drungilas Mantas
- du Plooy Flip
- Du Toit Frederick
- Duane Therese
- Duinhouwer Lucia
- Dulskas Audrius
- Ebidy Mai
- Ebidy Mai Mohamed
- Eid Mostafa Mahmoud
- El Dahab Ali Abo
- El Gendy Noran Halim
- El Halawany Mohamed
- El Jamassi Alaa
- El Kashash Ahmed
- El Sayed Islam Magdy
- El-Dien Khalid Salah
- El-Din Reham Alaa
- El-Din Shahinaz Alaa
- El-Gizawy Esraa
- El-Sagheer Nada
- El-Sawy Aya
- El-Sehily Ahmed
- El-Taher Esraa
- Elashry Rehab
- Elazab Alaa
- Elbanby Esraa Samir
- Elbe Peter
- Elbisomy Khaled Hesham
- Eldafrawy Mahmoud
- Eldeeb Ahmed Zaki
- Eldeen Esraa Alm
- Eldin Mostafa Ahmed Bahaa
- Elebute Olumide
- Elfarargy Arwa
- Elfeki Hossam
- Elfiky Mahmoud
- Elfouly Nesma
- Elfouly Yasmin
- Elgendy Alyaa Halim
- Elgheriany Mohammed
- Elhadad Alaa
- Elhadary Nourhan Medhat
- Elhadry Shady
- Elhalawany Esraa
- Elhamouly Sara
- Elhelbawy Mohamed Salah
- Elhendawy Abdelaziz
- Elhoseny Ghada
- Elhusseiny Ahmed Abd Elmoen
- Elkholy Shimaa Said
- Ellison Quinn
- Elmashala Amjad
- Elmasry Maha
- Elmihy Sohaila
- Elnagar Ahmedglal
- Elnajjar Mahmoud A
- Elrazek Aly Abd
- Elsabbagh Nourhan
- Elsameea Ahmed Abd
- Elsawy Amira
- Elsayed Nada Ahmed Reda
- Elsemelawy Rofida
- Elshaar Mohammed
- Elshaer Mohamed
- Elshami Mohamedraed
- Elsharkawy Aya Adel
- Elsherbiney Saged
- Elsherif Fawzia Abdellatif
- Elwy Eman
- Elzahed Nada
- Emadeldin Hossam
- Emara Eman
- Emile Sameh
- Eng Calvin
- English William
- Esam Abeer
- Escalante Salas Marilia Del Carmen
- Espin-Basany Eloy
- Espinoza Fernando
- Essam AA
- Essam Ahmed
- Essam Mahitab
- Essoun Samuel
- Esteban Enrique
- Estee Mahnuma Mahfuz
- Etchill Eric
- Etienne Sara
- Etwire Victor
- Evajelista Cicilia Viany
- Evans David
- Evans Elizabeth
- Ezzat Eslam
- Ezzat Tarek
- Faboya Omolara
- Fahim Marwan
- Fairfield Cameron
- Falaschi Federica
- Falco Nicolo
- Falzon Malcolm
- Farag Ahmed
- Farag Sameh
- Farahat Mahitab Morsy
- Fares Mohamed
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- Sharma Abhishek
- Sharpin Claire
- Shatkar Veeranna
- Shaw Catherine A
- Shaw Catherine A
- Shawky Martina Yusuf
- Shawqi Muhammad
- Sheshe Abdurrahaman
- Sheta Ahmed
- Shillito Sam
- Shiwani Haaris A
- Sholadoye Tunde
- Shrimanker Nikhita
- Shu Sebastian
- Shu Sebastian
- Shu Sebestian
- Shubianok Maryna
- Shwky Ayman
- Siaw Jia Yng
- Sierra Sebastian
- Sigurdadottir Johanna
- Sii Samuel SY
- Sileri Pierpaolo
- Silvestri Vania
- Simioni Andrea
- Simutis Gintaras
- Skerritt Clare
- Slapelyte Evelina
- Sleem Ahmad Saber
- Sleem Mohamed
- Smart Neil
- Smart Neil
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- Smith Christopher
- Sobnach Sanju
- Sokratous Arestis
- Solaini Leonardo
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- Soldevila-Verdeguer Carla
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- Soley Rafael
- Soliman Abdelrahman
- Soliman Ahmed
- Soliman Noha Abdullah
- Soliman Nourhan
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- Sollazzo Viviana
- Soon Wai Cheong
- Soreide Jon Arne
- Soreide Kjetil
- Soreide Kjetil
- Souaibou Yacoubou Imorou
- Soulou Vasiliki
- Spence Richard
- Spence Richard
- Spence Richard
- Spence Richard
- Sproule Lorraine
- Srinivasan Ravi
- Sroor Fathy
- Sruogiene Elena Zdanyte
- Steccanella Francesca
- Stefanopoulos Anastasios
- Stock Simon
- Stoddart Michael
- Stoddart Michael
- Stourton Frederick
- Strupas Kestutis
- Stuva Jessica
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- Suarez Aida
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- Sund Malin
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- Sutandi Nathania
- Suyadi Arlindawati
- Swaroop Mamta
- Syibrah Khuzaimah Zahid
- Tabiri Stephen
- Tabiri Stephen
- Tabiri Stephen
- Tabiri Stephen
- Tackie Enoch
- Taddei Antonio
- Tahboub Haya
- Taher Ayman And
- Taher Mustafa Mohammed
- Taieb Chouikh
- Taiwo Agboola
- Taiwo Ogechukwu
- Talaat Muhammed
- Tale Luis
- Talving Peep
- Talving Peep
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- Tan Choy Ling
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- Tan Keith Say Kwang
- Tan Ryan Choon Kiat
- Tan Yee Wen
- Tan Yi Koon
- Tang Lingshan
- Tani Sobhana Iftekhar
- Tansoker Ilkan
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- Tarek Dina
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- Tariq Sherif
- Tata Mahadevan Deva
- Tawfik Badreldin Adel
- Tawfik Gehad
- Teasdale Ella
- Teasdale Ella
- Teasdale Ella
- Tedeschi Umberto
- Tembo Thelma
- Tennakoon Athula
- Teo Shuang Yi
- Ter Eunice Zuling
- Tew Yong Yong
- Tew Yong Yong
- Thabet Waleed
- Thalgaspitiya SPB
- Theodosopoulos Theodosios
- Thollot Aurore
- Thorarinsdottir Hildur
- Thorell Anders
- Timothy Oyediran Kehinde
- Ting Jesse Ron Swire
- To Kathleen
- Tolonen Matti
- Tolotra Todisoa Emmanuella Christina
- Tomas Kadir
- Tori Sayeeda Aktar
- Toribio Orbegozo Pedro Angel
- Torrance Hew D
- Torres Cardozo Jorge
- Torres Rodriguez Servio Tulio
- Toto Omer Faruk
- Townsend Dominic
- Trompetto Mario
- Tselos Angelos
- Tshisola Serge Kapenda
- Tugnoli Gregorio
- Tun Myint
- Turati Luca
- Turkustani Sondos
- Turpo Espinoza Kenny
- Turpo Espinoza Kevin
- Tutino Roberta
- Tverskis Zygimantas
- Tyler Robert
- Tze R Goh Ern
- Tzikos Georgios
- Ubiali Paolo
- Ukwenya Yahaya
- ul Razi Syed Asaat
- Ulusahin Mehmet
- Upadhyaya Vijaid
- Urbonas Tomas
- Urniezius Zigmantas
- Uscinas Laimonas
- Uzabumwana Norbert
- Vaicius Arturas
- Valcarcel-Saldana Maria
- Valioulis Ioannis
- Van Der Naald Niels
- Van Niekerk Michael
- Van Straten Stephanie
- Vargas Marvin
- Vartanoglu Talar
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- Vasquez Idelso
- Veen Torhild
- Velasquez Ricardo
- Venclauskas Linas
- Vendramin Elena
- Venskutonis Donatas
- Venskutonis Donatas
- Verbeek Anna
- Vergara Mejia Angelica Genoveva
- Verjee Azmina
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- Vicario Erika
- Vicenta Collado Maria
- Vida Lucian Corneliu
- Vilcinskas Mantas
- Villalobos Santiago
- Violi Paola
- Visinskas Petras
- Voulgaris Evangelos
- Wael Noha
- Wakefield Rebecca
- Waledziak Maciej
- Walker Michael
- Walker Nathan
- Walls Luke
- Walsh Michael
- Waqar Muhammad
- Warren Oliver
- Waterman Ade
- Werder Gabriela
- Whitaker John
- White Rebecca
- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T Ariani
- Widmer Lukas Werner
- Wijayarathna LS
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Wilson Michael
- Wimalge PMSN
- Wogensen Fredrik
- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yap Suhhuey
- Yau Jih Dar
- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
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
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- 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
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- do Nascimento SD
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- 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
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