10 research outputs found
Characterization of Drug-Resistant Lipid-Dependent Differentially Detectable Mycobacterium tuberculosis
- Author
- Publication venue
- eScholarship@UMassChan
- Publication date
- 23/07/2021
- Field of study
An estimated 15-20% of patients who are treated for pulmonary tuberculosis (TB) are culture-negative at the time of diagnosis. Recent work has focused on the existence of differentially detectable Mycobacterium tuberculosis (Mtb) bacilli that do not grow under routine solid culture conditions without the addition of supplementary stimuli. We identified a cohort of TB patients in Lima, Peru, in whom acid-fast bacilli could be detected by sputum smear microscopy, but from whom Mtb could not be grown in standard solid culture media. When we attempted to re-grow Mtb from the frozen sputum samples of these patients, we found that 10 out of 15 could be grown in a glycerol-poor/lipid-rich medium. These fell into the following two groups: a subset that could be regrown in glycerol after lipid-resuscitation , and a group that displayed a heritable glycerol-sensitive phenotype that were unable to grow in the presence of this carbon source. Notably, all of the glycerol-sensitive strains were found to be multidrug resistant. Although whole-genome sequencing of the lipid-resuscitated strains identified 20 unique mutations compared to closely related strains, no single genetic lesion could be associated with this phenotype. In summary, we found that lipid-based media effectively fostered the growth of Mtb from a series of sputum smear-positive samples that were not culturable in glycerol-based Lowenstein-Jensen or 7H9 media, which is consistent with Mtb\u27s known preference for non-glycolytic sources during infection. Analysis of the recovered strains demonstrated that both genetic and non-genetic mechanisms contribute to the observed differential capturability, and suggested that this phenotype may be associated with drug resistance
Diagnostic Performance Assessment of Saliva RT-PCR and Nasopharyngeal Antigen for the Detection of SARS-CoV-2 in Peru
- Author
- Publication venue
- American Society for Microbiology
- Publication date
- 18/07/2022
- Field of study
Widely available and reliable testing for SARS-CoV-2 is essential for the public health response to the COVID-19 pandemic. We estimated the diagnostic performance of reverse transcription PCR (RT-PCR) performed on saliva and the SD Biosensor STANDARD Q antigen test performed on nasopharyngeal swab compared to the reference standard, nasopharyngeal swab (NP) RT-PCR. We enrolled participants living and/or seeking care in health facilities in North Lima, Peru from November 2020 to January 2021. Consenting participants underwent same-day RT-PCR on both saliva and nasopharyngeal swab specimens, antigen testing on a nasopharyngeal swab specimen, pulse oximetry, and standardized symptom assessment. We calculated sensitivity, specificity, and predictive values for the nasopharyngeal antigen and saliva RT-PCR compared to nasopharyngeal RT-PCR. Of 896 participants analyzed, 567 (63.3%) had acute signs/symptoms of COVID-19. The overall sensitivity and specificity of saliva RT-PCR were 85.8% and 98.1%, respectively. Among participants with and without acute signs/symptoms of COVID-19, saliva sensitivity was 87.3% and 37.5%, respectively. Saliva sensitivity was 97.4% and 56.0% among participants with cycle threshold (CT) values of #30 and .30 on nasopharyngeal RT-PCR, respectively. The overall sensitivity and specificity of nasopharyngeal antigen were 73.2% and 99.4%, respectively. The sensitivity of the nasopharyngeal antigen test was 75.1% and 12.5% among participants with and without acute signs/symptoms of COVID-19, and 91.2% and 26.7% among participants with CT values of #30 and .30 on nasopharyngeal RT-PCR, respectively. Saliva RT-PCR achieved the WHO-recommended threshold of .80% for sensitivity for the detection of SARS-CoV-2, while the SD Biosensor nasopharyngeal antigen test did not. IMPORTANCE In this diagnostic validation study of 896 participants in Peru, saliva reverse transcription PCR (RT-PCR) had .80% sensitivity for the detection of SARS-CoV-2 among all-comers and symptomatic individuals, while the SD Biosensor STANDARD Q antigen test performed on nasopharyngeal swab had,80% sensitivity, except for participants whose same-day nasopharyngeal RT-PCR results showed cycle threshold values of,30, consistent with a high viral load in the nasopharynx. The specificity was high for both tests. Our results demonstrate that saliva sampling could serve as an alternative noninvasive technique for RT-PCR diagnosis of SARS-CoV-2. The role of nasopharyngeal antigen testing is more limited; when community transmission is low, it may be used for mass screenings among asymptomatic individuals with high testing frequency. Among symptomatic individuals, the nasopharyngeal antigen test may be relied upon for 4 to 8 days after symptom onset, or in those likely to have high viral load, whereupon it showed .80% sensitivity.Revisión por pare
High prevalence and heterogeneity of Dysglycemia in patients with tuberculosis from Peru: a prospective cohort study
- Author
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2019
- Field of study
Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2019-10-29T11:51:28Z
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Previous issue date: 2019-01-11Consejo Nacional de Ciencia,
Tecnología e Innovación Tecnológica (CONCYTEC-Peru) / Fondo Nacional de
Desarrollo Científico, Tecnológico y de Innovación Tecnológica (FONDECYT,
Convenio 175–2015). The work from BBA was supported by intramural
research program from FIOCRUZ, by the National Institutes of Health
(U01AI115940 and U01AI069923) and by the Departamento de Ciência e
Tecnologia (DECIT) - Secretaria de Ciência e Tecnologia (SCTIE) – Ministério
da Saúde (MS), Brazil (25029.000507/2013–07). MBA receives a fellowship
from the Fundação de Amparo à Pesquisa da Bahia (FAPESB). BBA is a senior
scientist from the Conselho Nacional de Desenvolvimento Científico e
Tecnológico.Socios en Salud Sucursal Peru. Lima, Peru / Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil.Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Fundação José Silveira. Instituto Brasileiro para Investigação da Tuberculose. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil.Socios en Salud Sucursal Peru. Lima, Peru.Socios en Salud Sucursal Peru. Lima, Peru.Socios en Salud Sucursal Peru. Lima, Peru.Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brasil.Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brazil.Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Harvard Medical School / Department of Global Health and Social Medicine. Boston, MA, USA.Socios en Salud Sucursal Peru. Lima, Peru / Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Fundação José Silveira. Instituto Brasileiro para Investigação da Tuberculose. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative. Salvador, BA, Brasil / Faculdade de Tecnologia e Ciências. Curso de Medicina. Salvador, BA, Brasil / Universidade de Salvador. Salvador, BA, Brasil /Escola Bahiana de Medicina e Saúde Pública. Salvador, BA, Brasil.The accuracy of different laboratory tests for diagnosis of diabetes mellitus (DM) and prediabetes (preDM) in populations exposed to tuberculosis (TB) remains poorly understood. Here, we examined the prevalence of DM and preDM in TB affected people in Lima, Peru. Methods: A prospective cohort study of patients affected TB and their household contacts (HHC), was conducted
between February and November 2017 in Lima, Peru. Fasting plasma glucose (FPG), HbA1c and oral glucose
tolerance test (OGTT) were used to detect DM and preDM in a prospective cohort of TB patients (n = 136) and
household contacts (n = 138). Diagnostic performance of the laboratory tests was analyzed. Potential effects of
sociodemographic and clinical factors on detection of dysglycemia were analyzed.
Results: In TB patients, prevalence of DM and preDM was 13.97 and 30.88% respectively. Lower prevalence of both
DM (6.52%) and preDM (28.99%) were observed in contacts. FPG, HbA1c and OGTT had poor agreement in
detection of preDM in either TB cases or contacts. TB-DM patients had substantially lower hemoglobin levels, which
resulted in low accuracy of HbA1c-based diagnosis. Classic sociodemographic and clinical characteristics were not
different between TB patients with or without dysglycemia.
Conclusion: High prevalence of DM and preDM was found in both TB patients and contacts in Lima. Anemia was
strongly associated with TB-DM, which directly affected the diagnostic performance of HbA1c in such population
Dysglycemia is associated with Mycobacterium tuberculosis lineages in tuberculosis patients of North Lima-Peru.
- Author
- Publication venue
- 'Public Library of Science (PLoS)'
- Publication date
- 01/01/2021
- Field of study
This study was performed to investigate the role of dysglycemia on the genetic diversity of Mycobacterium tuberculosis (MTB) among pulmonary tuberculosis (TB) patients to build scientific evidence about the possible mechanisms of TB transmission. MTB isolates obtained of patients affected by pulmonary tuberculosis from health care facilities of North Lima-Peru, were analyzed using whole genome sequencing and 24-locus mycobacterial interspersed repetitive-unit -variable-number tandem repeats (MIRU-VNTR). Subsequently, clinical and epidemiological characteristics were associated with clustering, lineages and comorbid conditions. The analysis carried out 112 pulmonary TB patients from various health centers in North Lima, 17 (15%) had diabetes mellitus (DM) and 33 (29%) had pre-diabetes (PDM). Latin American-Mediterranean, Haarlem and Beijing were the most frequent MTB lineages found in those patients. Previous TB (adjusted odds ratio [aOR] = 3.65; 95%CI: 1.32-17.81), age (aOR = 1.12; 95%CI: 1.03-1.45) and Beijing lineage (aOR = 3.53; 95%CI: 1.08-13.2) were associated with TB-DM comorbidity. Alcoholism (aOR = 2.92; 95%CI: 1.10-8.28), age (aOR = 1.05; 95%CI: 1.03-1.12) and Haarlem lineage (aOR = 2.54; 95%CI: 1.04-6.51) were associated with TB-PDM comorbidity. Beijing and Haarlem lineages were independently associated with TB-DM and TB-PDM comorbidities, respectively. Although these findings may be surprising, we must be cautious to suggest that dysglycemia could be associated with a highly clustering and predisposition of MTB lineages related to a serious impact on the severity of TB disease, which requires further research
Global economic burden of unmet surgical need for appendicitis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Mohamed
- Abbasy Jibran
- Abbo Olivier
- Abbouch Meryem
- Abd-Elmawla Manar
- Abd-Elrasoul Yasmin
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdel-Wahab Nehal Yosri Elsayed
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- AbdelFattah Ibrahim
- Abdelgelil Asmaa
- Abdelghany Sarah
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkareem Ahmed
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraheim Mohamed
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshafy Mahmoud
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulbagi Omar
- Abdulgawad Mahmoud
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abebe Nebiyou Seyoum
- Abebe Nebyou Seyoum
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboarab Aya
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboraya Metwally
- Aboraya Mohammad
- Abouelnasr Alaa
- Aboul-Naga Mariam Saad
- Abouzahra Amany
- Abouzaid Arwa
- Abozaid Mohamed
- Abozeid Khaled
- Abozyed Mahmoud Ahmed Fathi
- Abu-toyour Maram
- Abubakr Marwan
- Abudeeb Haytham
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abuseif Mohamed
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Nourhan
- Adams Ryan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adekoya Adeleke
- Adel Abdalrahman
- Adel Ahmed
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji O
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adesuyi Abidemi
- Adeyeye Ademola
- Adham Walid
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O
- Adnan Ahmad Bin
- Adu-Aryee Niiarmah
- Afana Samah
- Afandy Ahmed
- Afifi Ahmed Mohamed
- Africa South
- Agalianos Christos
- Agarwal Arnav
- Agbedinu Kwabena
- Agius Marija
- Aglan Amro
- Aguilar Wendy Leslie Messa
- Aguilar-Jimenez Jose
- Aguilera Maria Lorena
- Aguilera Omar
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahmed Ahmed
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Emad Ali
- Ahmed Hala
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahmed Soliman Magdy
- Ahounou Ernest Yemalin Stephane
- Aigrain Yves
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi E
- Ajiboye Anthony
- Akatibo Emmanuel
- Akeel Nouf
- Akoto Elliot
- Al-Aarag Asmaa Abdel-Rahman
- Al-Azraqi Israa Abdullah Aziz
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-Faifi Jubran J
- Al-faqawi Maha
- Al-farram Hadeel
- Al-Hameedi Hasan Ismael Ibraheem
- Al-Hasani Ruqaya Kadhim Mohammed Jawad
- Al-khatib Ahmed
- Al-Mallah Abdullah
- Al-Marakby Dina
- Al-Mousa Mashael
- Al-Nahrawi Safwat
- Al-Obaedi Ossama
- Al-saqqa Sara
- Al-Saqqa Sara W
- Al-shammari Abeer
- Al-Slaibi Ibrahim
- Al-taher Taher
- Alada Muslimat
- Alahmady Omar
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Alamoudi Uthman
- Albeladi Bandar
- Albiety Adel
- Aldalaq Ahmad
- Aldhafeeri Salman
- Aledrisy Mohannad
- Alexander Philip
- Alexandre Challine
- Alfarsi Muayad Ahmed
- Alghamdi Ahmed
- Alghamdi Basim
- Alghamdi Masood
- Alghamdi Mohammed Saleh A.
- Algohary Osama
- Alhabli Ibrahim
- Alhady Khaled
- Alhassan Basmah
- Alhazmi Wedyan
- Alhendy Mohammed
- Alherz Mohammad
- Ali Ahmad
- Ali Ahmed
- Ali Ased
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Farah Mahmoud
- Ali Hussein
- Ali Safia
- Ali Samuel Sani
- Ali Syed Abdul Wahhab Eusoffee Wan
- Ali Tebian Hassanein Ahmed
- Alihonou Thierry
- Alimi Quentin
- Aliyu Halima
- Aliyu Mohammad
- Aliyu Shamsudeen
- Aljboor Khaled
- Aljiffry Murad
- Aljohani Emad
- Aljohani Saud
- Alkaaki Aroub
- Alkammash Abdelrahman
- Alkelani Muhammad
- Alkhabbaz Dalia
- Allam Meran
- Allam Mostafa
- Allam Yomna
- Allegri Andrea
- Allen John Lee Y
- Almallah Ahmad
- Almanon Christel Leanne
- Almoflihi Abdullah
- Almuallem Sultan
- Almy Jack
- Alnaby Mohamed Hassab
- Alnawam Ehab
- Alnuqaydan Saleh A.
- Alnusairat Aseel
- Alomar Ibrahim N.
- Alqahtani Enas
- Alqahtani Saleh
- Alrahawy Mahmoud
- Alrajraji Mawaddah
- Alrifaie Ahmad
- AlRowais Mohammed
- Alsaggaf Mohammed
- Alsaggaf Mohammed Ubaid
- Alser Osaid H.
- Alshareef Reham
- Altaf Abdulmalik
- Altamimi Abdullah
- Altamimi Afnan
- Altamini Afnan
- Altarayra Marwa
- Althwainy Amani
- Altibi Ahmed
- Altinel Yuksel
- Altoe Fernanda
- Altwigry Abdulrahman M.
- Altwijri Abdulaziz
- Alvarez Ismael Isaac Zelada
- Alvi Abdul Rehman
- Alwafai Mohammad Ghassan
- Aly Abouelatta Khairy
- Aly Mohammed Yahia Mohamed
- Alyacoubi Said
- Alyahya Reem
- Alyami Rifan
- AlYoussef Ibrahim
- Alzahrani Ahmed
- Alzahrani Mohammed
- Alzayat Thuraya
- Aman Nowrin F.
- Amandito Radhian
- Ambrozeviciute Viktorija
- Ameen Mohamed
- Amer Mohamed A
- Amin Hager Abdul Aziz
- Amin Jasim
- Amin Shadid Al
- Amjad Mohammadasim
- Ammar Mohamed
- Ammar Mohamed Sabry
- Amoah Michael
- Amoako Joachim
- Amoako Philip Taah
- Amoako-Boateng Mabel
- Amole Isaac
- Amreia Mahmoud
- Anderson-Knight Hannah
- Andersson Linda
- Andika Ferry Fitriya Ayu
- Andreotti Dario
- Angelieri Daniele
- Anis Echaieb
- Ansaloni Luca
- Antar Sarah
- Antezana Diego
- Anthoulakis Christos
- Antoniozzi Angelo
- Anwar Abdul Wahid
- Anwar Nourhan
- Anwer Wahid
- Anyanwu Lofty-John
- Aonzo Paolo
- Appeadu-Mensah William
- Appiah Eric Kofi
- Aql Shaimaa
- Aquilino Fabrizio
- Arachchi Prasad Pitigala
- Arachchige Lalith Asanka Jayasooriya Jayasooriya
- Arafa Omar
- Arafa Sara
- Arango Maria Clara Mendoza
- Araujo Rafael
- Arcudi Claudio
- Ardley Rohan
- Arenas Andy
- Aristizã¡bal Fred Alexander Naranjo
- Arman Sam
- Armellini Andrea
- Arnaud Alexis Pierre
- Arshad Mohammad Mohsin
- Arsyad Hasbi Maulana
- Arthur Tom
- Arulampalam Tan
- Aruldas Neerav
- Asal Mohamed
- Asar Yomna Hosny
- Asare-Bediako Kwasi
- Asele Frehun Ayele
- Ashal Gehad El
- Ashour Ahmad
- Ashour Khlood
- Ashtari Morvarid
- Ashton Annelisse
- Asi Fatema
- Asilah Siti Mohd Desa
- Assal Abdelrahman
- Assouto Pamphile A
- Asturias Sabrina
- Asumah Hamza
- Ata Ahmed
- Ata Ali Amin Ahmed
- Ata Aya Yehia
- Atiyeh Anwar
- Atkins Ebenezer Takyi
- Atkinson Kieran
- Atobatele Kazeem
- Attallah Noura A.
- Attar Samaa Mahmoud Al
- Attard Myranda
- Attia Attia
- Attia Attia Mohamed
- Augestad Knut Magne
- Aung Kyaw Phyo
- Austraite Aiste
- Aviles Susan
- Avoka Anthony
- Awad Israa
- Awad Sawsan Adel
- Awuku-Asabre Joseph
- Awwad Saad Al
- Ayad Sara
- Ayandipo Omobolaji O
- Ayyar Shruti
- Aziz Dayang Nita Abdul
- Aziz Mohamed Rezal Abdul
- Aziz Nora Abdul
- Azizeldine Mohammed G.
- Azmitia José René Arévalo
- Azzie Georges
- Azzis Olivier
- Baba Suleiman
- Bachri Houda
- Badawy Mahmoud
- Badenjki Mohamed Adel
- Badr Ahmed
- Badr Mohamed Fawzy Mahrous
- Badwi Nermin M
- Badwi Nermin Mohamed
- Badwy Assmaa
- Bahar Suraya
- Baheeg Mohamad
- Bailey Karen
- Baird Alan
- Bakhaidar Mohamad
- Bakr Ahmad
- Bakry Hesham Mohammed
- Bala Miklosh
- Balalis Dimitrios
- Baldacchino Matthew
- Balducci Genoveffa
- Balila Reem Mohammed Hassan
- Balkan Ali Zeynel Abidin
- Ball Alasdair
- Ballouhey Quentin
- Balmaceda Rubén
- Balogun Fatai
- Baltrunas Robertas
- Baluch Fatima
- Bamicha Anastasia
- Bamicha Athanasia
- Banaitis Vincas Jonas
- Bandoh Dickson
- Bani-Sadar Ahmad
- Banipal Gurpreet Singh
- Baraka Heba
- Barakat Sara Abd Elmageed
- Barendegere Venerand
- Barkolias Christos
- Barnabas Gandau Naa
- Barneo Luis
- Barrantes Ana Maria Sandoval
- Barrawi Fayez Elian Al
- Barreda Luis Miguel Alvarez
- Barrientos Linda Alvi Madrid
- Barrios Emanuel
- Barrios Emmanuel
- Basilicò Silvia
- Basir Elissa Rifhan Mohd
- Bassem Monica
- Bassit Khalil Abdul
- Basso Celeste Del
- Basso Stefano M. M
- Bastawis Fatema Al
- Basto Carlos Alejandro Arroyo
- Bautista Ana Cecilia Manchego
- Beasley William
- Bedada Alemayehu Ginbo
- Bediako-Bowan Antoinette
- Behar Nebil
- Beisa Virgilijus
- Bekhet Amira Hassan
- Bekhet Nada Mohamed
- Beleño Alvaro Enrique Mendoza
- Belkouchi Abdelkader
- Belli Andrea
- Bello Bashir
- Benammi Sarah
- Benevento Angelo
- Bennai Redouane Mammar
- Bentounsi Zineb
- Benyaiche Chaymae
- Bermúdez Ysabel Esthefany Alejos
- Berti Stefano
- Bertuello Isaac
- Beuran Mircea
- Bezzina Maureen
- Bhangu Aneel
- Bhat Sriram
- Bhatnagar Ankur
- Bhopal Kamran Faisal
- Bianco Federica
- Bigaran Annamaria
- Billy Matthew
- Birindelli Arianna
- Birring Amerdip
- Björklund Ida
- Blanco Ruth
- Blencowe Natalie
- Bliksøen Marte
- Blower Emma
- Boakye-Yiadom Kwaku
- Bocchetti Tommaso
- Bode Chris
- Bode Christopher
- Boijsen Magnus
- Bonavia Karl
- Bonavina Luigi
- Bondin John
- Bondurri Andrea
- Boni Davide De
- Boni Silvia
- Bonnard Arnaud
- Bonney William
- Bono Phoebe De
- Borda-Luque Giuliano
- Borg Elaine
- Borin Eva
- Bortolasi Luca
- Botero Jaime Andres Montoya
- Botes Stefan
- Bottini Corrado
- Botto Nathalie
- Bouali Ourdia
- Bougard Heather
- Boukhal Khaoula
- Bowabsak Alaa
- Bowe Ross
- Bowley Doug
- Bradulskis Saulius
- Bratu Matei
- Bratu Matei Razvan
- Bratu Razvan-Matei
- Braungart Sarah
- Bravo Jorge Armando Chungui
- Bray Lemuel Davies
- Breitenstein Stefan
- Bréaud Jean
- Brincat Svetlana Doris
- Brocca Antonella La
- Broch Aline
- Brown Damien
- Brown James
- Brown Jason
- Brunoni Beatrice
- Bsisu Isam
- Bucci Luigi
- Bugeja Roberta
- Buisson Philippe
- Bukari Mohammed
- Burger Sule
- Burmistrovas Andrius
- Burns Hannah
- Bustangi Nasir
- Butt Muhammad Talha
- Cabrera Carla Cecilia Ramãrez
- Cacurri Alban
- Cadogan Diana Duarte
- Cahill Ronan
- Callan Rory
- Calua Alexander Canta
- Camacho Rony
- Cameron Brian
- Camilleri Georgette Marie
- Camilleri-Brennan John F.
- Camilleri-Brennan Julian
- Campagnaro Tommaso
- Canto Massimiliano Dal
- Capito Carmen
- Carabott Kurt
- Cardozo Jorge Torres
- Cardozo Ramón Augusto Melo
- Careta Maíra Cassa
- Carlucci Michele
- Carmona Juan Manuel
- Carpio Juan
- Carrasco Nahilia
- Carreira Jo-Anne
- Cassar Kristina
- Castillo Vanessa Dina Palomino
- Castro Manuel Rodriguez
- Catani Marco
- Cautiero Roberto
- Cecilia Tolg
- Celis Jose María Vergara
- Cengiz Yücel
- Ceriani Chiara
- Chachulski Witold
- Chai Chu-Ann
- Chai Feng Yih
- Chan Tsz-Yan Katie
- Chan Xue Wei
- Chang Kate Yu-Ching
- Chapman Stephen J
- Charles Angeline
- Cheah Alvin Ee Zhiun
- Chen Tzu-Ling
- Chenn Roxanne
- Cheong Yih Jeng
- Chetta Nicola
- Cheung Yuk Hong Eric
- Chew Luen Shaun
- Chibuye Chali
- Chiesa Deborah
- Chin Pui Xin
- Chiong Jose Antonio Cabala
- Chiu Selina
- Chiu Selina Man Yeng
- Choi Philip
- Chong Bryon Frankie Hon Khi
- Chong Chean Leung
- Chong Choon Seng
- Chong Hoong-Yin
- Chow Crystal Yern Nee
- Chu Kathryn
- Chung Kuet Jun
- Chung Siyi
- Ciccioli Eleonora
- Cirocchi Roberto
- Ciubotaru Cezar
- Claire Raquillet
- Clarissa Audrey
- Clegg-Lamptey Joe-Nat
- Clement Keiran David
- Clements Joshua Michael
- Clerico Giuseppe
- Clifford Caroline
- Cloro Luigi Maria
- Coccolini Federico
- Cocker DM
- Cocorullo Gianfranco
- Cohen David Monterroso
- Coletta Diego
- Coletti Massimo
- Colombani Jean-Francois
- Cona Camilla
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- Elsawy Amira
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- Elsayed Mohammed
- Elsayed Nada Ahmed Reda
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- Haroun Abdelrahman
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- Migliore Marco
- Miguel Gustavo Peixoto Soares
- Mihaljevic Andre L
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- Shamsi Ghina Shamim
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- Shatkar Veereanna
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- Shawki Marwan
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- Shehata Sherif
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- Sheshe Abdurrahaman
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- Tatagiba Luiza Sarmento
- Tawfik Badreldin Adel
- Tawfik Gehad
- Teasdale Ella
- Tedeschi Umberto
- Tedjaatmadja Chintya
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- Teufelberger Gerfried
- Tew Yong Yong
- Tewari Shirish
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- Thanusan Vimalakanthan
- Tharmalingam Shivanee
- Theodosopoulos Theodosios
- Thollot Aurore
- Thomas Efeson
- Thomas Hannah S
- Thompson Ben
- Thorarinsdottir Hildur
- Thorell Anders
- Thorsen Kenneth
- Ticona Willy Alcca
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- Toeema Aliaa Gamal
- Toit Frederick Du
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- Tolg Cecilia
- Tolonen Matti
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- Trompetto Mario
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- Tun Aung Kyaw
- Tun Myint
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- Turkustani Sondos
- Turner Megan
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- Tyler Robert
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- Tze Reuben Goh Ern
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- Ubiali Paolo
- Ugalde Paul
- Ukwenya Yahaya
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- Upadhyaya Vijaid
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- Urniežius Zigmantas
- Urquizu Mario Contreras
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- Uzabumwana Norbert
- Vaicius Arturas
- Valcarcel-Saldaña María
- Valioulis Ioannis
- Vargas Marvin
- Varkalys Karolis
- Vartic Mihaela
- Vasquez Giorgio
- Vasquez Idelso
- Veen Torhild
- Vega Gustavo Miguel Machain
- Velasquez Ricardo
- Velásquez Armando José Román
- Velásquez Carlos Iván Pérez
- Vella-Baldacchino Martinique
- Venclauskas Linas
- Vendramin Elena
- Venskutonis Donatas
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- Veronese Ezio
- Vianna Julia Guasti Pinto
- Vicario Erika
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- Villa Roberta
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- Vimalachandran Dale
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- Walędziak Maciej
- Walsh Michael
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- Watts Anna
- Weber Beatrix
- Weber Per
- Weiser Thomas G
- Wheeler James
- Whitaker John
- White Timothy
- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T Ariani
- Wild Jonathan R L
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Witherspoon Paul
- Wogensen Fredrik
- Woin Evelina
- Wold Trude Beate
- Wolf Bernhard
- Wondimu Sahlu
- Wondoh Paul
- Wong Chee Siong
- Wong Chui Yee
- Wong Hong Yee
- Wood Greta
- Woodward Helen
- Worku Mengistu
- Worku Tewodros
- Wredberg Cecilia
- Wright Naomi J
- Xerri Thelma
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yaseen Tahir
- Yaseen Tahir Muhammad
- Yavuz Mehmet Ali
- Ye Joselyn
- Yeang Li Jing
- Yeo Lee Shi
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yip Chingwan
- Yip Sebastian Bernardo Shu
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yong Cheryl Ou
- Yong Guo Liang
- Youssef Daniel
- Youssef Haney
- Youssef Mohamed
- Youssif Jehad Hassan
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zachariades Dimitris-Christos
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zalabia Mohamed F
- Zamarin Kresimir
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zardab Ali
- Zegarra Sergio
- Zerihun Abebe Bekele
- Zhang Zhongtao
- Zheng Fei
- Zidan Hagar
- Zidan Mohamed
- Ziff Oliver
- Zil-E-Ali Ahsan
- Zohair Ahmed
- Zuber Markus
- Zulkifli Athirah
- Žilinskas Justas
- Žilinskienė Reda
- Žiubrytė Greta
- Publication venue
- 'Oxford University Press (OUP)'
- 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
Global economic burden of unmet surgical need for appendicitis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Mohamed
- Abbasy Jibran
- Abbo Olivier
- Abbouch Meryem
- Abd-Elmawla Manar
- Abd-Elrasoul Yasmin
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdel-Wahab Nehal Yosri Elsayed
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- AbdelFattah Ibrahim
- Abdelgelil Asmaa
- Abdelghany Sarah
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
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- Elsawy Amira
- Elsayed Makki
- Elsayed Mohammed
- Elsayed Nada Ahmed Reda
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- Farfan Erick Samuel Florez
- Farhad Mustafa
- Farhan-Alanie Muhamed M H
- Farinella Eriberto
- Farmakis Konstantinos
- Farouk Sara Amr Mohamed
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- Fowler Alexander J
- Fozard Thomas
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- Tawfik Badreldin Adel
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- Teufelberger Gerfried
- Tew Yong Yong
- Tewari Shirish
- Thabet Waleed
- Thanusan Vimalakanthan
- Tharmalingam Shivanee
- Theodosopoulos Theodosios
- Thollot Aurore
- Thomas Efeson
- Thomas Hannah S
- Thompson Ben
- Thorarinsdottir Hildur
- Thorell Anders
- Thorsen Kenneth
- Ticona Willy Alcca
- Timothy Oyediran Kehinde
- Ting Jesse Ron Swire
- Toeema Aliaa Gamal
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- Tolba Hager
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- Upadhyaya Vijaid
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- Uzabumwana Norbert
- Vaicius Arturas
- Valcarcel-Saldaña María
- Valioulis Ioannis
- Vargas Marvin
- Varkalys Karolis
- Vartic Mihaela
- Vasquez Giorgio
- Vasquez Idelso
- Veen Torhild
- Vega Gustavo Miguel Machain
- Velasquez Ricardo
- Velásquez Armando José Román
- Velásquez Carlos Iván Pérez
- Vella-Baldacchino Martinique
- Venclauskas Linas
- Vendramin Elena
- Venskutonis Donatas
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- Waleed Hamza
- Walędziak Maciej
- Walsh Michael
- Waqar Muhammad
- Warda Mahmoud
- Warren Oliver
- Waterman Ade
- Watts Anna
- Weber Beatrix
- Weber Per
- Weiser Thomas G
- Wheeler James
- Whitaker John
- White Timothy
- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T Ariani
- Wild Jonathan R L
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Witherspoon Paul
- Wogensen Fredrik
- Woin Evelina
- Wold Trude Beate
- Wolf Bernhard
- Wondimu Sahlu
- Wondoh Paul
- Wong Chee Siong
- Wong Chui Yee
- Wong Hong Yee
- Wood Greta
- Woodward Helen
- Worku Mengistu
- Worku Tewodros
- Wredberg Cecilia
- Wright Naomi J
- Xerri Thelma
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yaseen Tahir
- Yaseen Tahir Muhammad
- Yavuz Mehmet Ali
- Ye Joselyn
- Yeang Li Jing
- Yeo Lee Shi
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yip Chingwan
- Yip Sebastian Bernardo Shu
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yong Cheryl Ou
- Yong Guo Liang
- Youssef Daniel
- Youssef Haney
- Youssef Mohamed
- Youssif Jehad Hassan
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zachariades Dimitris-Christos
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zalabia Mohamed F
- Zamarin Kresimir
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zardab Ali
- Zegarra Sergio
- Zerihun Abebe Bekele
- Zhang Zhongtao
- Zheng Fei
- Zidan Hagar
- Zidan Mohamed
- Ziff Oliver
- Zil-E-Ali Ahsan
- Zohair Ahmed
- Zuber Markus
- Zulkifli Athirah
- Žilinskas Justas
- Žilinskienė Reda
- Žiubrytė Greta
- Publication venue
- 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
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aad Sinha
- Aamal Ebrahem
- Abay Jumanov
- Abd El-Fattah Mouhandes
- Abdalla Emhareb
- Abdalrahmman G Abdalradiy
- Abdelmalek Ousadden
- Abdelrahman Mahmoud
- Abdenour Aissat
- Abdi Tessema
- Abdullah Kağan Zengin
- Abdulrahman Abba Sheshe
- Abdurrahman Aremu
- Abelevich Alexnder
- Abhishek Chaudhari
- Abhishek Chitnis
- Abid Jamal
- Abidemi Akere
- Abigail Hallett
- Abiodun Okunlola
- Abu Bakr H Widatalla
- Abubakar Ballah
- Abubakar Muhammad Bala
- Abylai Baimakhanov
- Adam Walsh
- Adamu Ningi
- Adegbolahan Fakoya
- Ademola Adeyeye
- Adnan Hacim
- Adolfo Pisanu
- Adriana Galaviz Muro
- Afia Arshed Dodhy
- Aghyad Kudra Danial
- Agnieszka Fiedziuk
- Agnieszka Kubisz-Pudelko
- Ahmad Al Jabar
- Ahmad Saad
- Ahmad Sakr
- Ahmad Shehu
- Ahmad Suhaimi Amir
- Ahmed Abaidalla
- Ahmed Abd El Aal
- Ahmed Abdellatif
- Ahmed Al-Alnsi
- Ahmed Ali
- Ahmed Elfallal
- Ahmed Nafea
- Ahmed Ragab
- Ahmed Shehta
- Ahmed Siddique Ammar
- Ahmet Akbas
- Ahmet Aşkar
- Ahmet Burak Ciftci
- Ahmet Ipek
- Ahmet Necati Şanlı
- Ahsan Hussain
- Aicha Bengueddach
- Ainhoa Valle Rubio
- Ajeet Pratap Maurya
- Ajesh Raj Saksena
- Ajit Kumar
- Akanksha Sharma
- Akihiko Horiguchi
- Akram Gharbi
- Alaa El-Hussuna
- Alaa Hamdan
- Alam Noor Khan
- Albano Silva
- Albash Sarwar
- Alberto Biondi
- Alberto Mondini
- Alberto Porcu
- Alberto Roxo
- Alberto Silva
- Alejandro Espí-Macías
- Alejandro Hoyos-Torres
- Alejandro Marcelo Doniquian
- Alejandro Mitidieri
- Alejandro Romero-De Diego
- Aleksander Dychko
- Aleksandra Baker
- Aleksei Karachun
- Aleksei Petrov
- Alelign Tasew
- Alena Naiqiso
- Alena Rybachuk
- Alessandra Grazia Giuseppina Garau
- Alessandra Marano
- Alessandra Novi
- Alessandro Arturi
- Alessandro Cois
- Alessandro Iacomino
- Alessandro Vasale
- Alessandro Zapparoli
- Alessio Palumbo
- Alexander Bogatikov
- Alexander Forero-Torres
- Alexander Hoetzel
- Alexander Shin
- Alexander V Lodygin
- Alexandra Charakopoulou
- Alexandra Triantafyllou
- Alexandre Carvalho
- Alexandre da Silveira Sete
- Alexey Yanishev
- Alfredo Alonso
- Alfredo Gallardo
- Ali Akbar
- Ali Mansour
- Aliaa Shamardal
- Alican Güreşin
- Alice Frontali
- Alice Ryl
- Alicia Ruiz-De-La-Hermosa
- Alina Capusan
- Alison Marshall
- Alma Blazquez-Martin
- Almir Miftari
- Almudena Castro Calvo
- Aloysius Okoye
- Alvarado José
- Alysson Bomfa-Barbosa
- Amal Singh
- Aman Bhargava
- Amane Hammed
- Amar Al-Jarrah
- Amari Thompson
- Ameer Afzal
- Amier Mohamed Rashed
- Amine Benkabbou
- Amine Khayreddine Ghouali
- Amine Souadka
- Amit Mahajan
- Amjed Yassir Ahmed
- Ammar Niazi
- Amparo Camacho
- Amr Hamza
- Amrit Pipara
- An Windels
- Ana Assis
- Ana Belen Pedregosa
- Ana Cláudia Deus
- Ana Faustino
- Ana Isabel Rodrigues
- Ana Llamazarez Llamazares
- Ana Loscos
- Ana Lozano Valbuena
- Ana Margarida Coelho
- Ana María Minaya-Bravo
- Ana Martins
- Ana Minaya Bravo
- Ana Minaya-Bravo
- Ana Otero
- Ana Ribeiro
- Ana Sanches
- Ana Torre
- Ana-Maria Musina
- Anabela Santos
- Anabella Houdin
- Analia Potolicchio
- Anam Butt
- Anamaria Luca
- Anastasia Novikova
- Anatoliy Shudrak
- Anca-Irina Ristescu
- Andee Dzulkarnaen Zakaria
- Anders Høgn
- Anderson Barbosa
- Andre Fernandes
- Andrea Bruni
- Andrea Felice Ferroni
- Andrea Fernandez Pujol
- Andrea Galimberti
- Andrea Mingoli
- Andrea Muratore
- Andrea Peri
- Andrea Pisani Ceretti
- Andrea Porta
- Andrea Vázquez-Fernández
- Andrea Vignali
- Andrea Zanoni
- Andreas Jud
- Andreas Polidorou
- Andrei Chitul
- Andrei Domanskiy
- Andrei Pasca
- Andreia Amado
- Andreia Ferreira
- Andrejs Pcolkins
- Andres Valenzuela
- Andrew Ekwesianya
- Andrew Kakeeto
- Andrew Woodward
- Andrey Koshel
- Andrey Litvin
- Andrey Zaycev
- André Marçal
- André Pacheco
- Andrius Macas
- Andriy Beznosenko
- Andrzej Kwiatkowski
- Ane Abad-Motos
- Aneel Bhangu
- Angel Arabadzhiev
- Angel Martin de Pablos
- Angela Belvedere
- Angela Correia
- Angela Genoefa Rudell
- Angela Marzella
- Angela Romano
- Angeliki Petra
- Angelo Antonio Ciccarese
- Anil Chacko
- Anil Ghosh
- Anil Tore
- Anisse Tidjane
- Anna Ekepil
- Anna Feiss
- Anna Kapustina
- Anna Lawrence
- Anna Los
- Anna Mori
- Anna Panagiotou
- Anna Paola Sanesi
- Anna Wątroba
- Anna Zappone
- Annamaria Minicozzi
- Anne Marie Camilleri Podesta
- Anthony Lin
- Anton Sumbaev
- Antonella Di Trani
- Antonia Pascual
- Antonino Spinelli
- Antonio Cappiello
- Antonio Castaldi
- Antonio Hilário Freitas
- Antonio Maria de Lacy
- Antonio Melero Abellán
- Antonio Pesce
- Antonios Gklavas
- António Freitas
- António Oliveira
- António Pires
- Antônio Lacerda Filho
- Antti Väyrynen
- Anu Carpelan
- April Roslani
- Arai Aitbaeva
- Aras Emre Canda
- Arcangelo Picciariello
- Archana Khanduri
- Arda Isik
- Arda Ulaş Mutlu
- Ardak Arynov
- Arend Merrie
- Ari Kechagias
- Aridai Resendiz
- Ariel Grinblat
- Arina Provozina
- Aristeidis Papadopoulos
- Aristidis Mpakas
- Arkadeep Dhali
- Arkady Bedzhanyan
- Armando Galván-Pérez
- Armands Sivins
- Armen Vardanyan
- Armin Belarmino
- Arnaldo Machado
- Arto Turunen
- Arturan Ibrahimli
- Arun Chaturvedi
- Arzu Koklucan
- Asad Kerawala
- Ashish Shrestha
- Ashish Shukla
- Ashwani Kumar
- Asif Mehraj
- Asuncion Perez-Sanchez
- Athanasia Kikira
- Athanasios Marinis
- Athanasios Xanthis
- Athina Samara
- Athula Tennakoon
- Atiqur Rahman
- Audrius Dulskas
- Augusto Carrie
- Augusto Lauro
- Aun Jamal Gill
- Aurora Pinto
- Auxiliadora Cano-Matias
- Awais Malik
- Aya Haji Mohamad
- Aya Zazo
- Aylin Incesu
- Aymen Kutkut
- Ayr Nasser Júnior
- Ayra Suleman
- Aysegul Ferlengez
- Aziza El Metwally
- Álvaro Soler Silva
- Åsa Lindén
- Badareesh Lakshminarayana
- Bala Mahesh Polamreddy
- Balaji Jayasankar
- Balázs Bánky
- Baljit Singh
- Banu Vural Gökay
- Baraa Shebli
- Barbara Proietto
- Barbara Sanna
- Baris Gulcu
- Barış Mantoğlu
- Basanth Kumar Rayani
- Basel Refky
- Bashiru Aminu
- Bassam Oqaili
- Baver Baris
- Bayan Saada
- Beatriz Amorós Alfonso
- Beatriz de Andrés-Asenjo
- Beatriz Diéguez
- Beatriz Díaz San Andrés
- Beatriz Mendes
- Begoña Fadrique Fernández
- Begoña González Sierra
- Begoña Toribio-Combarro
- Bei En Siew
- Ben Creavin
- Benali Tabeti
- Benicia Perez Leon
- Benita Adams
- Benson Oguttu
- Berik Dzhumabekov
- Bernard Costa Favacho
- Bernarda Bakmaz
- Bernardo Hanan
- Bernice Theodore
- Betina Møller
- Béatrice Pinard
- Bhagya Gunetilleke
- Bharath Veerabhadrappa S
- Bianca Santos
- Billy Jimenez Bobadilla
- Bodhisattva Bose
- Bogdan Stoica
- Bojan Kovacevic
- Boyko Atanasov
- Brahim El Ahmadi
- Brenda Chayanny Alves
- Breno Xaia Martins Costa
- Brett E Dawson
- Bruno Giusti Werneck Cortes
- Bruno Lucena de Souza Pires
- Bruno Scotto
- Bruno Sensi
- Calin Ionescu
- Camelia Calin
- Camilla Cremonini
- Camille Nobile
- Camino Morales Marcos
- Can Arican
- Can Saraçoğlu
- Candeniz Erturk
- Carina Chwat
- Carina Gomes
- Carina Yumi Takahashi
- Carla Galmes
- Carla Mariela Gonzalez
- Carla Pinto
- Carlo Bergamini
- Carlo Maria Neri
- Carlo V Feo
- Carlos Augusto Real Martinez
- Carlos Gracia Roche
- Carlos Ruiz-Lozano
- Carlos San Miguel-Méndez
- Carmel Dawson
- Carmela Cervone
- Carmelo Mazzeo
- Carmine Antropoli
- Carolina Martínez Pérez
- Caroline Witjes
- Carolyn Cullinane
- Carolynne Vaizey
- Carsten Fütterer
- Casiraghi Umberto
- Catalin Vlad
- Catalina Simeanu
- Catarina Lareiro
- Caterina Foppa
- Catherine Victor
- Cati Diaconescu
- Catia Sbarbaro
- Cátia Ferreira
- Cemil Caliskan
- Cezar Ciubotaru
- Chakib Behilil
- Chamaidi Sarakatsianou
- Chandrashekhar Mahakalkar
- Chang Woo Kim
- Chantal de Kort
- Charalampos Theodoropoulos
- Charles Berlo Van
- Charles Cini
- Charles H Knowles
- Charles Knowles
- Charlotte Dempsy
- Charlotte Hill
- Charmaine Shovelton
- Chaves Pablo
- Che Saniati Che Ali
- Chetan Parmar
- Chiara de Lucia
- Chiara Leoni
- Chiemelu Emegoakor
- Chimdiebele Nwosu
- Chin Wee Ang
- Chor Kuan Yew
- Chris Coldwell
- Chris Varghese
- Christina Delimpalta
- Christine Paterson
- Christoph Reißfelder
- Christopher Liao
- Chu Yik Tang
- Chukwuemeka Nwoye
- Chukwuma Okereke
- Chun Hin Angus Lee
- Cian Davis
- Ciciliot Massimo
- Cihad Tatar
- Claire Carden
- Claire Kilbride
- Claudia Armellin
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- Tatiana Revez
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- Tatyana Sapronova
- Tatyana Tverdohlebova
- Tayfun Bisgin
- Tayfun Kaya
- Tayfun Yoldas
- Tayseer Tawarh
- Tecla Tedde
- Teresa Ferraz
- Teresa Perra
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- Tesleem Orewole
- Thaisa Barbosa Silva
- Thaisa Silva
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- Theodoros Sidiropoulos
- Theodosios Theodosopoulos
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- Thomas Teare
- Tiffany Atendido
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- Tom Anderson
- Tomas Poskus
- Tomás Elosua Gonzalez
- Tomáš Grolich
- Tommaso Dominioni
- Tope Olatiilu
- Toshinori Kobayashi
- Triada Papadopoulou
- Tricarico Juan
- Trudi Young
- Tsvetomir Ivanov
- Tuncay Yilmazlar
- Turkan Sel Ozker
- Turna Gezer
- U Aravindan
- Ugo Elmore
- Ugo Grossi
- Ugur Sungurtekin
- Umar Masoro
- Umberto Bracale
- Ummuhan Vural
- Umut Kara
- Usama Waqar
- Utku Ozgen
- Vaishali Waindeskar
- Valdemaras Jotautas
- Valentina Madalina Negoita
- Valentina Testa
- Valeria Tonini
- Valerio Donatiello
- Vamsi Velchuru
- Vanesa Crespo Garcia Del Castillo
- Vania Fernandes
- Varun Sarodaya
- Varun Vijayan
- Varut Lohsiriwat
- Vasco Pereira
- Vasil Pavlov
- Vasile Bintintan
- Vasile Deac
- Vasileia Nyktari
- Vasileos Papadopoulos
- Vasiliki Nikolaou
- Vera Gonçalves
- Vera Pedro
- Veronica Romero
- Veronika Rozhkova
- Vicent Primo
- Vicente Muñoz Lopez-Pelaez
- Vicente Pla-Marti
- Victor A Kashchenko
- Victor Baptista
- Victor Gonzabay
- Victor Hugo Bruno Cao
- Victor Manuel Maciel Gutierrez
- Victoria Fraj
- Victoriano Soria-Aledo
- Vida Hamilton
- Vihara Dassanayake
- Vijay Kumar
- Vijaykumar Ishwarappagol
- Viktor Kakotkin
- Villamarín Ricardo
- Ville Falenius
- Vincenzo Francesco Tripodi
- Vincenzo Papagni
- Vincenzo Pazzola
- Vincenzo Signorelli
- Vincenzo Sorce
- Vincenzo Vigorita
- Viola Menduni
- Virginia Jimenez Carneros
- Virginia Laurenti
- Virginia Moreno
- Vitalii Zvirych
- Vitaliy Stamov
- Vittoria Bellato
- Vivian Nga Man Lau
- Vlad Alexandru Gata
- Vlad Dudric
- Vlad Fagarasan
- Vlada Bernotaite
- Vladimir Balaban
- Volkan Ozben
- Wafa Sabri
- Walid A S Mohmmad
- Walid Rezoug
- Wan Zainira Wan Zain
- Wasantha Wijenayake
- Wei Ming Ong
- Wilhelmina Somera
- Will Loh
- William Marshall
- William Prem
- Wilson Manuel Sánchez Bautista
- Wing Kin Tse
- Wisam Hasan
- Wladimiro Siciliano
- Won-Suk Lee
- Xavier Guedes
- Xrysoyla Livanou
- Yahya Abou El-Wafa
- Yasemin Kirmizi
- Yasin Kara
- Yaşar Subutay Peker
- Yathev Balathayalan
- Yenny Quiroga
- Yeoh Chih Nie
- Yi Chien Hsieh
- Yolanda Olivella
- Young Song
- Youngbae Jeon
- Yucel Karadere
- Yukio Asano
- Yuksel Altinel
- Yulia Frolova
- Yuriy Pelipas
- Yvonne Mouvet
- Zahed Abu Arida
- Zaidi Zakaria
- Zain Douba
- Zairul Azwan Mohd Azman
- Zakiah Mohd Yusoff
- Zaman Mamedli
- Zameer Shah
- Zaure Dushimova
- Zdeněk Kala
- Zewude Gudisa
- Zilvinas Saladzinskas
- Zinash Teferu
- Zoe Garoufalia
- Zoe Gates
- Zumrud Aliyeva
- Zülfü Bayhan
- Zvonimir Katušić
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aarts Frits
- Ababneh Hazim
- Abad-Motos Ane
- Abaidalla Ahmed
- Abbakar Malaz
- Abd El Aal Ahmed
- Abd-Errazik Mohammad Ahmad
- Abdalradiy Abdalrahmman G
- Abdelkhalek Mohamed
- Abdelkhalek Mostafa
- Abdellatif Ahmed
- Abdellatif Mohamed
- Abdelsaid Kirolas
- Abdou Khaled
- Abdulfatah Mustapha
- Abdullah Mohammad Amer
- Abdullahi Mustapha Miko Mohammed
- Abellán Antonio Melero
- Abeysinghe Nayana
- Abiyere Henry
- Achimas-Cadariu Patriciu Andrei
- Adakaya Sıla
- Adam Nicolas
- Adams Benita
- Adams Ferdinand
- Adegboye Kazeem
- Adeyeye Ademola
- Adra Lama
- Adu-Poku Patricia
- Afuwape Oludolapo
- Afzal Ameer
- Afzal Muhammad Farooq
- Agapov Mihail
- Agara Daniel
- Aggarwal Manisha
- Agger Erika
- Aghadi Ifeanyi Kene
- Ahmed Amjed Yassir
- Ahmed Haleemasahdia
- Ahmed Khalil
- Ahmed Manar
- Ahmed Masood
- Ahmed Safia
- Ahn Hong Min
- Aibe Raquel
- Aigner Felix
- Aissat Abdenour
- Aitbaeva Arai
- Akay Omer
- Akbar Ali
- Akbas Ahmet
- Akçay Özlem
- Akere Abidemi
- Akesen Selcan
- Akgun Erhan
- Akhtar Naseem
- Akın Emrah
- Akova Elif
- Aktas Serhat
- Al Masri Mahmoud
- Al-Alnsi Ahmed
- Al-Hutheifi Roqia'A
- Al-Jarrah Amar
- Al-Naggar Hamza
- Al-Shehari Mohammed
- Alamin Nadeen
- Alawi Raneen
- Alawlaqi Dina
- Alawneh Fade
- Alberola Maria José
- Albers Michael
- Alcolea Natalia González
- Aleem Muhammad
- Alegre Inês
- Alegre Javier Martinez
- Alexandre Flavia
- Alexandrescu Corina
- Alexnder Abelevich
- Alexopoulou Kalliopi
- Alfonso Beatriz Amorós
- Ali Ahmed
- Ali Che Saniati Che
- Ali Danish
- Ali Madeeha
- Ali Mahmoud Abdelwahab
- Ali Manhal Hashim
- Ali Noura Al
- Alikhanli Jhale
- Aliyeva Zumrud
- Aliyu Mohammed
- Aljawder Hasan
- Allen Kate
- Almahmeed Ebrahim
- Alonso Alfredo
- Alonso Javier Etreros
- Alsamneh Muneer
- Alsayadi Ramzi
- Altinel Yuksel
- Altintoprak Fatih
- Altomare Donato F
- Alvarenga Isabella
- Alvarez Laura Jimenez
- Alvarez-Bautista Francisco Emmanuel
- Alvarez-Díez Marcos
- Alves Brenda Chayanny
- Amadigwe Rita
- Amado Andreia
- Amado Fabíola
- Amador Cristina García
- Amanullah Nazli
- Amaral Hélida Aline Tomacheski
- Amaral Luis
- Amin-Tai Hizami
- Aminu Bashiru
- Amir Ahmad Suhaimi
- Ammar Ahmed Siddique
- Ammar Mona Ahmed
- Ammendola Michele
- Ammerata Giorgio
- Amorim Edgar
- Ancans Guntis
- Anderson Tom
- Andrade Diogo
- Andrejevic Predrag
- Andrés Beatriz Díaz San
- Anestiadou Elissavet
- Ang Chin Wee
- Angelo Franceschi
- Anokhin Evgeny
- Anoldo Pietro
- Antakia Ramez
- Anton Majd
- Antonelli Serena
- Antropoli Carmine
- Anula Rocio
- Anwar Jamal
- Anyadike Florence
- Apostolakidou Magda
- Apostolidi Eirini
- Aprea Giovanni
- Arabadzhiev Angel
- Arakawa Satoshi
- Arauz Jazmin
- Aravindan U
- Aremu Abdurrahman
- Aremu Isiaka
- Argawy Osama
- Arican Can
- Arida Zahed Abu
- Armellin Claudia
- Arnaoutoglou Eleni
- Arreguy-Borges Kanthya
- Artigot Mariano
- Arturi Alessandro
- Arulappan Nirupama
- Arya Shobhit
- Arynov Ardak
- Asaad Peter
- Asano Yukio
- Ascari Francesca
- Asgarov Mohsum
- Ashmawy Soad
- Aslam Muhammad Imran
- Assimakopoulou Elena
- Assis Ana
- Astilleta Romina
- Aşkar Ahmet
- Atanasov Boyko
- Atendido Tiffany
- Athanasakis Elias
- Atici Semra Demirli
- Avellaneda Nicholas
- Avellaneda Nicolas
- Avseren Goksu
- Awead Marwa
- Ayandipo Omobolaji
- Aybar Engin
- Aydin Funda
- Aydin Gaye
- Ayoub Kusay
- Aytac Erman
- Aytaç Erman
- Azevedo Jose
- Azevedo Patricia
- Azhar Najia
- Aziz Gowhar
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- Yague Julio
- Yakout Nadia
- Yakunina Natalia
- Yalkin Ömer
- Yanishev Alexey
- Yao Hongwei
- Yazici Pinar
- Yemez Kursat
- Yew Chor Kuan
- Yiğit Direnç
- Yılmaz Gülseren
- Yilmazlar Tuncay
- Yoldas Tayfun
- Yonekura Hiroshi
- Yorkmui Liu
- Yoshino Kenji
- Younes Lina
- Young Trudi
- Yule Michael
- Yusoff Zakiah Mohd
- Zaari Fatimazahraa
- Zabiyaka Mikhail
- Zadrożna Monika
- Zafar Madiha
- Zagaynov Eugeny
- Zaidi Syed-Nadeem
- Zaimis Tilemachos
- Zain Wan Zainira Wan
- Zainy Rhendra Hardy Mohamad
- Zakaria Andee Dzulkarnaen
- Zakaria Maheen
- Zakaria Zaidi
- Zamudio-Bautista Jorge Luis
- Zanc Loredana
- Zanoni Andrea
- Zanus Giacomo
- Zapparoli Alessandro
- Zappone Anna
- Zarzava Eirini
- Zatari Dirar
- Zawadzki Marek
- Zayakov Georgi
- Zaycev Andrey
- Zazo Aya
- Zazo Rama
- Zdravkovic Maja
- Zengin Abdullah Kağan
- Zeringa Georgia
- Zimmerman David D E
- Zuhdy Mohammad
- Zvirych Vitalii
- Zywicka Ewa
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)
Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries
- Author
- A Yacoub Mina
- A. Adam Mohammed
- A. Nassar Mahmoud
- A.Nemer Ayoob
- Aahlin Eirik Kjus
- Ab Rahim Mohd Fadliyazid
- Abad Gurumeta Alfredo
- Abad-Motos Ane
- Abang Jamari Dyg Zahratul Hamrak
- Abantanga Francis
- Abarca Sol
- Abazid Eias
- Abbas Abbas
- Abbas Khalid
- Abbas Mohammad Monir
- Abbasy Jibran
- Abbosh Ali
- Abd Karim Muhammad Fairuz Shah
- Abd Wahab Haidar Hadri
- Abd Barook
- Abdalei Abdulwahab
- Abdalla Ahmed Elkamel Ahmed
- Abdallah Aya
- AbdAllah Mostafa Salim Mohamed
- Abdel Malik Abu Baker
- Abdelhady Mousa Heba
- Abdelhady Samar
- Abdelhakim Ahmed
- Abdelkader Muhammad
- Abdelkawy Shaza
- Abdelkhalek Mohamed
- Abdellatif Esraa
- Abdelmaksoud Tawakel Noura
- Abdelmohsen Naglaa
- Abdelmotaleb Ibrahem
- Abdelrazek Aly
- Abdelsalam Israa
- Abdelshakour Mahmoud
- Abdelwahed Ahmed Mohamed
- Abdou Abdulrahman Osama
- Abdou Alrawy
- Abdou Hossam
- Abdul Aziz Mohamed Rezal
- Abdul Aziz Nora
- Abdulgawad Almogy Mariam
- Abdulla Mazin A.
- Abdullah Muhammad Tariq
- Abdullahi Lawal
- Abdullayev Seymur
- Abed Saeed
- Abelló David
- Abiola Olajide
- Abo mahadi Asmaa'
- Abo-khammash Areej
- Abou Chaar Mohamad K.
- Abou El.soud Moustafa Ramadan
- Abouelsoad Nervana
- Abraham Joyner
- Abreu da Silva Alberto
- Abu Ahammala Ayman B.
- Abu Al Amrain Mahmoud
- Abu Al-saleem Hasan
- Abu Alamrain Abdulwhhab
- Abu Alqumboz Amjad
- Abu Ataya Ahmed
- Abu hallalah Muad fathi khalleefah
- Abu Jamie Najlaa
- Abu Jayyab Israa
- Abu shua'ib Rana
- Abu Zainah Baraa
- Abu-Nimeh Samar
- Abu-Rous Mohammed R.
- Abu-srour Abrar
- Abuelhatal Hasan
- Abuelqomboz Ayham
- Abuhilal Baseel
- Abuhlaiga Ma'aly
- Abujamra Saleh
- Abukhalaf Sadi A.
- Abusalem Lana
- AbuSirrees Mahmoud
- Acevedo Veronica
- Acharya Rajgopal
- Achkasov Sergey
- Acosta Eric
- Adamo Karin
- Adamou Harissou
- Adams Jamie
- Adams Lawrence
- Adawi Samer
- Adebanjo Ademola
- Adel Marina
- Adel Sawsan
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji
- Adenuga Adedire
- Aderounmu Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adesunkanmi Abdul-Rashid
- Adeyeye Ademola
- Adidharma Peter
- Adisa Adewale O
- Adnan Nour
- Afifi Amr Abdelghani
- Afifi Eman
- Afolayan Michael Olatunji
- Afzal Asma
- Agarwal Arnav
- Agarwal Raksheeth
- Agbakwuru Augustine
- Agbeko Anita Eseenam
- Aguilar Martinez Maria Del Mar
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlqvist Sandra
- Ahmad Izzuddin Ahmad Imran
- Ahmad Kasim
- Ahmad Sarwat
- Ahmed Ahmedgaber
- Ahmed Hazem Abdelkarem
- Ahmed Mariam
- Ahmed Nabila
- Ahmed Zahra
- Ainoa Eppu
- Aithie Joanna M S
- Ajani Costanza
- Ajao Akinlabi
- Ajiboye Anthony
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- Al-Allaf Omar
- Al-Busaidi Ibrahim S.
- Al-Dhufri Ali
- Al-Himyari Hamza S.
- Al-Masri Mahmoud
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- Eusebio Zegarra Ivan Edward
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- NA N.A.
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- Zabiyaka Mikhail
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- Zafar Syed Nabeel
- Zaffaroni Gloria
- Zahra Baryab
- Zahran Diaaaldin
- Zakaria Andee Dzulkarnaen
- Zakaria Mai
- Zakaria Omar
- Zakaria Zaidi
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- Zammit Matthew
- Zanini Nicola
- Zara Vlu Jean
- Zara Vlu Jean
- Zarti Heba
- Zarzycki Piotr
- Zattoni Davide
- Zavala Gabriela
- Zawahrah Hassan
- Zeiton Asaid
- Zeko Amanda
- Zeng Zhi
- Zeromskas Paulius
- Zhang Geoffrey
- Zhivkov Evgeni
- Zid Esraa
- Zidan Ahmed Mohy
- Zielasek Christian
- Zilinskas Justas
- Zimmermann Bernd
- Ziprin Paul
- Zizzo Maurizio
- Zografos George
- Zoikas Athanasios
- Zorrilla Matilla Laura Patricia
- Zoulamoglou Menelaos
- Zreeg Dafer
- Zub-Pokrowiecka Anna
- Zubiaurre Vanessa
- Zuhdy Mohammed
- Zuikyte Diana
- Zuloaga Fernandez del Valle Carlos Jose
- Zulu Stanley
- Ângelo Miguel
- Älgå Andreas
- Çolak Elif
- Ümarik Toomas
- Šatkauskas Mindaugas
- Škimelyte Monika
- Šlenfuktas Vygintas
- Šuman Oliver
- Žatecký Jan
- Žumbakys Žygimantas
- Župan Domagoj
- Publication venue
- 'Elsevier BV'
- Publication date
- 30/01/2021
- Field of study
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
- Author
- A Yacoub Mina
- A. Adam Mohammed
- A. Nassar Mahmoud
- A.Nemer Ayoob
- Aahlin Eirik Kjus
- Ab Rahim Mohd Fadliyazid
- Abad Gurumeta Alfredo
- Abad-Motos Ane
- Abang Jamari Dyg Zahratul Hamrak
- Abantanga Francis
- Abarca Sol
- Abazid Eias
- Abbas Abbas
- Abbas Khalid
- Abbas Mohammad Monir
- Abbasy Jibran
- Abbosh Ali
- Abd Karim Muhammad Fairuz Shah
- Abd Wahab Haidar Hadri
- Abd Barook
- Abdalei Abdulwahab
- Abdalla Ahmed Elkamel Ahmed
- Abdallah Aya
- AbdAllah Mostafa Salim Mohamed
- Abdel Malik Abu Baker
- Abdelhady Mousa Heba
- Abdelhady Samar
- Abdelhakim Ahmed
- Abdelkader Muhammad
- Abdelkawy Shaza
- Abdelkhalek Mohamed
- Abdellatif Esraa
- Abdelmaksoud Tawakel Noura
- Abdelmohsen Naglaa
- Abdelmotaleb Ibrahem
- Abdelrazek Aly
- Abdelsalam Israa
- Abdelshakour Mahmoud
- Abdelwahed Ahmed Mohamed
- Abdou Abdulrahman Osama
- Abdou Alrawy
- Abdou Hossam
- Abdul Aziz Mohamed Rezal
- Abdul Aziz Nora
- Abdulgawad Almogy Mariam
- Abdulla Mazin A.
- Abdullah Muhammad Tariq
- Abdullahi Lawal
- Abdullayev Seymur
- Abed Saeed
- Abelló David
- Abiola Olajide
- Abo mahadi Asmaa'
- Abo-khammash Areej
- Abou Chaar Mohamad K.
- Abou El.soud Moustafa Ramadan
- Abouelsoad Nervana
- Abraham Joyner
- Abreu da Silva Alberto
- Abu Ahammala Ayman B.
- Abu Al Amrain Mahmoud
- Abu Al-saleem Hasan
- Abu Alamrain Abdulwhhab
- Abu Alqumboz Amjad
- Abu Ataya Ahmed
- Abu hallalah Muad fathi khalleefah
- Abu Jamie Najlaa
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- Dollie Qaasim
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- Dominguez Joaquina
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- Essam Ibrahim El Desouki Muhammad Ahmed Muhammad
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- Figueiredo Ana Gabriela
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- Gnintedeme Olivier Tchianze
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- Wogensen Fredrik
- Wondoh Paul M.
- Wong Florence
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- Wong Jeremy
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- Wong Tsz Lun Ernest
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- Yabut Kenneth
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- Yaghi Yasmine
- Yahia Mohamed Ali Mohamed
- Yakushkina Al'ona
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- Yang P Zichu
- Yanikoğlu Erkan
- Yanni Fady
- Yates Charlotte
- Ye Geoffrey
- Yeen Chin Leow
- Yemez Kürşat
- Yenidünya Nilüfer
- Yenli Edwin
- Yeo Jeremy
- Yeoh Andrea
- Yepez Raul
- Yeşilsancak Merve
- Yildirim Reyyan
- Yildiz Alp
- Yilmaz Duygu
- Yip Ching Wan
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- Yong Shun Qi
- Yoong Andrel
- Yorke Joseph
- Yotsov Tsanko
- You Lucia
- Younes Eman
- Younes Maha
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- Yozgatli Tahir Koray
- Yu Kristin
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- Yunes Asmaa
- Yusuf Baasil
- Yüksel Osman
- Zabiyaka Mikhail
- Zachariah Sanoop Koshy
- Zafar Syed Nabeel
- Zaffaroni Gloria
- Zahra Baryab
- Zahran Diaaaldin
- Zakaria Andee Dzulkarnaen
- Zakaria Mai
- Zakaria Omar
- Zakaria Zaidi
- Zambrana Campos Vanesa
- Zammit Matthew
- Zanini Nicola
- Zara Vlu Jean
- Zarti Heba
- Zarzycki Piotr
- Zattoni Davide
- Zavala Gabriela
- Zawahrah Hassan
- Zeiton Asaid
- Zeko Amanda
- Zeng Zhi
- Zeromskas Paulius
- Zhang Geoffrey
- Zhivkov Evgeni
- Zid Esraa
- Zidan Ahmed Mohy
- Zielasek Christian
- Zilinskas Justas
- Zimmermann Bernd
- Ziprin Paul
- Zizzo Maurizio
- Zografos George
- Zoikas Athanasios
- Zorrilla Matilla Laura Patricia
- Zoulamoglou Menelaos
- Zreeg Dafer
- Zub-Pokrowiecka Anna
- Zubiaurre Vanessa
- Zuhdy Mohammed
- Zuikyte Diana
- Zuloaga Fernandez del Valle Carlos Jose
- Zulu Stanley
- Ângelo Miguel
- Älgå Andreas
- Çolak Elif
- Ümarik Toomas
- Čepuliené Daiva
- Şahin Can
- Šatkauskas Mindaugas
- Škimelytè Monika
- Šlenfuktas Vygintas
- Šuman Oliver
- Žatecký Jan
- Žumbakys Žygimantas
- Župan Domagoj
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/07/2022
- Field of study
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: 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. Funding: National Institute for Health and Care Research