10 research outputs found
Perceived Teaching Efficacy and its Correlation with Achievement among Studentteachers in Childhood Education Program at the University of Jordan
- Author
- Publication venue
- 'King Saud University'
- Publication date
- 01/05/2016
- Field of study
This study aimed at investigating the perceived teaching efficacy of student- teachers in Childhood Education Program at the University of Jordan. The sample of the study consisted of (106) female student- teachers registered in the second semester (2013-2014). The Teacher Efficacy Scale (TES) developed by Gibson and Dembo (1984) was used to collect the data of this study. After it was translated in to Arabic, the validity and reliability of the scale were established prior to collecting data. Means and standard deviations were calculated to measure the level of perceived teaching efficacy of student- teachers. Person correlation coefficient was also computed to measure correlation between teaching efficacy and academic achievement, t test, in addition to "Chi square" (χ2). Results showed that student teachers had high level of teaching efficacy. Results also revealed a positive correlation between teaching efficacy and academic achievement of student- teachers. The researcher suggested a number of recommendations for other researchers, teacher educators and kindergartens' principals
Practices and Beliefs Relating to Authentic Assessment of Kindergarten Teachers in the Suburbs of Jerusalem
- Publication venue
- 'Canadian Center of Science and Education'
- Publication date
- 25/02/2019
- Field of study
This study aimed at investigating kindergarten teachers’ practices and beliefs relating to authentic assessment. The
study also aimed at investigating differences in teachers’ practices and beliefs based on level of education, study
major, and length of experience. The sample of the study consisted of (92) teachers working in kindergartens in
the suburbs of Jerusalem. Two questionnaires were developed and implemented to collect the data of the study. In
addition, individual semi-structured interviews were conducted with 20 teachers from the sample of the study.
Content analysis of some kindergarten documents was also used. The results showed that worksheets were the
main method used to assess children learning, while project-based assessment was not used at all. In addition, the
results showed significant differences in the teachers’ utilization of authentic assessment methods relating to level
of education and study major, but there were no differences relating to the length of the teachers teaching
experience. The teachers showed a strong belief in the importance of authentic assessment methods. The results of
the interviews and content analysis supported the findings of the questionnaires. The study concluded a number of
recommendations for future research, teacher educators and kindergarten principals
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
- Author
- Abantanga F
- Abbas M
- Abbo O
- Abd El Galeel A
- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elrasoul Y
- Abdallah E
- Abdel-Wahab NYE
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelkader M
- Abdelkareem A
- Abdelraheim M
- Abdelshafy M
- Abdulgawad M
- Abdullah AAN
- Abdullah NAN
- Abebe NS
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- Aber A
- Abington E
- Aboarab A
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- Abozyed MAF
- Abudeeb H
- Abuseif M
- Acharya P
- Adams R
- Adebanjo A
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- Adeniran J
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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
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- Abaliksta T
- Abantanga F
- Abantanga F
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- Abd El Hameed OS
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- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elmawla M
- Abd-Elrasoul Y
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- Abdel-Kader SM
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- El Halawany M
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- Elfouly Y
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- Elgendy FI
- Elgheriany M
- Elhadad A
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- Elhelbawy MS
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- Elhusseiny AAE
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- Elkady F
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- Espinoza F
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- Faure A
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- Fawzy A
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- Felipe CO
- Fergany A
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- Lytras D
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- Macchitella Y
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- Macfarlane A
- Machaca M
- Machain Vega GM
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- Maciejec L
- Madiba T
- Madkor MH
- Madrid Barrientos LA
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- Manchego Bautista AC
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- Manfreda S
- Mangan C
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- Mangiapane M
- Manipal CE
- Maniscalco A
- Mann T
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- Mano MJB
- Manrique Sila G
- Manrique Sila GC
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- Mansor EY
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- Menegussi J
- Mensah E
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- Merlo MS
- Mesbah N
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- Mirghani D
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- Mirza A
- Mirza S
- Mistry A
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- Mitroudi M
- Mitroudis N
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- Moe TT
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- Mohamed B
- Mohamed F
- Mohamed I
- Mohamed M
- Mohamed MA
- Mohamed MAEH
- Mohamed MM
- Mohamed O
- Mohamed SR
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- Mohammad A
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- Mohammed MMH
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- Montoya Botero JA
- Montrimaite M
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- Mosalum O
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- Mostafa M
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- Nanthakumaran S
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- Samaraweera DI
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- Snyder E
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- Sobnach S
- Sodde P
- Soeselo DA
- Sokratous A
- Solaini L
- Solar Garcia L
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- Soldevila-Verdeguer C
- Soley R
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- Soltani N
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- Srinivasan R
- Sriram A
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- Staerkle RF
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- Sundstrom SM
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- Tan KSK
- Tan RCK
- Tan YK
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- Tanase A
- Tang A
- Tang L
- Tani SI
- Tansoker I
- Tarek A
- Tarek A
- Tarek D
- Targa S
- Tariq S
- Tata MD
- Tatagiba LS
- Tawfik BA
- Tawfik G
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- Tedeschi U
- Tedjaatmadja C
- Telfah MM
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- Temoche E
- Tennakoon A
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- Thalgaspitiya SPB
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- Tharmalingam S
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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
Mortality of emergency abdominal surgery in high-, middle- and low-income countries
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- A A Ibrahem
- A A Maghrabi
- A A Nasir
- A A Ne'ma Abdullah
- A Abd El Galeel
- A Abdel-Rahman Al-Aarag
- A AbdelFattah
- A Abdelgelil
- A Abdelkareem
- A Abdelmotaleb Ghazy
- A Aber
- A Abo El Magd
- A Abo Elazayem
- A Aboarab
- A Abouelnasr
- A Abouzahra
- A Adebanjo
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- U Alamoudi
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- U Gustafsson
- U Hantour
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- U Walsh
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- V Beisa
- V D Palomino Castillo
- V Despotidis
- V Gadhvi
- V Graffeille
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- W L Messa Aguilar
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- W Milligan
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- W S M Kithsiri Janakantha Senanayake
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- Y Sinha
- Z Chan
- Z Dambrauskas
- Z Hassan
- Z Iftikhar
- Z Jaffry
- Z Mikwar
- Z Oof
- Z Urniezius
- Z Zhang
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2016
- Field of study
Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).
Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.
Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days.
Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
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- Asare-Bediako K
- Asele Fa
- Ashour A
- Ashour A
- Ashour K
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- Ashtari M
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- Asi F
- Asilah Smd
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- Ata Aaa
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- Atobatele K
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- Attard M
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- Attia Am
- Augestad Km
- Aung Kp
- Austraite A
- Aviles S
- Avoka A
- Awad I
- Awad Sa
- Awadallah S
- Awuku-Asabre J
- Ayad S
- Ayandipo O
- Ayandipo Oo
- Aydin Mc
- Ayyar S
- Aziz Dna
- Aziz Mra
- Aziz Na
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- Azodo Ia
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- Azzis O
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- Badenjki Ma
- Badicel M
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- Badwi Nm
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- Baki Be
- Bakr A
- Bakry Hm
- Baky Fahmy MA
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- Baldacchino M
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- Ballouhey Q
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- Balmaceda R
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- Bamford R
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- Barendegere V
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- Barmayehvar B
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- Barnacle J
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- Barreda Lma
- Barrientos Lam
- Barrios E
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- Barrios E
- Barry J
- Basilicò
- Basir Erm
- Bassem M
- Bassit Ka
- Basso Sm
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- Bautista Acm
- Bayram S
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- Bediako-Bowan A
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- Beisa V
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- Bekhet Nm
- Beleñ
- Belkouchi A
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- Benammi S
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- Benevento A
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- Benyaiche C
- Bermú
- Bernardo Cg
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- Bhattacharya S
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- Bhopal Kf
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- Bjö
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- Blacker S
- Blackwell J
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- Blanco-Colino R
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- Blencowe N
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- Blower E
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- Bode C
- Bodur S
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- Bonavina L
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- Borg E
- Borg E
- Borin E
- Bortolasi L
- Bortolasi L
- Boshnaq M
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- Bradulskis S
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- Bukari M
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- Bustangi N
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- Cardozo Ram
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- Castro Mr
- Catani M
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- Chai Fy
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- Chiong Jac
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- Chun T
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- Chung S
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- Clegg-Lamptey Jn
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- D&apos
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- D&apos
- Da Silva LA
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- Das K
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- Dasari M
- Dashnyam E
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- Dawnay G
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- Dayie M
- De Boni D
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- De Bono P
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- De La Medina AR
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- Dell A
- Dempster E
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- Depalma N
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- Der Y
- Dervenis C
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- Deutschmann P
- Devadasar Gh
- Dharamshi Ha
- Dhillon D
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- Di Martino N
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- Diaconescu Ib
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- Dick L
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- Dindyal S
- Dissanayake T
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- Domini E
- Domini E
- Donnelly P
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- Dorismé
- Dos Santos DV
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- Drake Tm
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- Duffy L
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- El Magd AA
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- El Salam YA
- El Sayed GS
- El Sayed IM
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- El-Ma&apos
- El-Rabaa S
- El-Sagheer N
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- El-Sawy A
- El-Sehily A
- El-Shahat Ns
- El-Sheemy H
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- Elabdin Hz
- Elashmawy M
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- Elazayem Aa
- Elazoul M
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- Elbatahgy A
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- Eldin Mab
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- Elebute O
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- Elfeki H
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- Elkorashy Am
- Ellison Q
- Elmashala A
- Elmasry M
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- Elmihy S
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- Elnajjar Ma
- Elnemr Ae
- Elrasoul Ya
- Elrazek Aa
- Elsabbagh N
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- Elsawahly Dme
- Elsawy A
- Elsayed M
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- Elsayed Zm
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- Elsehimy M
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- Elshaer M
- Elshafay Ae
- Elshami M
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- Elsherbiney S
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- Elsherif Fa
- Elshobary M
- Elsiddig M
- Elsobky S
- Elsorogy Deaa
- Elwaey A
- Elwakil H
- Elwan A
- Elwan A
- Elwy E
- Elzahed N
- Elzayat I
- Elzayat M
- Elzayyat I
- Elzowawi F
- Emadeldin D
- Emadeldin H
- Emara E
- Emile S
- Eng C
- English W
- Esam A
- Escobar Eg.
- Espin-Basany E
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- Espinoza Kt
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- Essam A
- Essam Aa
- Essam M
- Essoun S
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- Estupinian S
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- Etchill E
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- Etman M
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- Ezzat E
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- Fahiem A
- Fahim M
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- Fairfield C
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- Falco N
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- Farah A
- Farahat Mm
- Faraz A
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- Farhan-Alanie Mmh
- Farhangmehr N
- Farinella E
- Farmakis K
- Farooq T
- Farouk Sam
- Farquharson A
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- Farrugia A
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- Fattah Aa
- Fatuga A
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- Faturoti O
- Faure A
- Fautz T
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- Fawzy A
- Feidantsis T
- Felipe Co
- Fergany A
- Fergusson Sj
- Fergusson Sj
- Fergusson Sj
- Fermani C
- Fermani Cg
- Ferná
- Fernandes C
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- Ferousis C
- Ferreira Sak
- Ferrero E
- Fievet L
- Filatau A
- Findlay-Cooper K
- Firdouse M
- Firdouse M
- Firdouse M
- Firwana A
- Fitsum A
- Fitzgerald Je
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- Foco M
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- Foo Cc
- Forlin L
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- Fouad D
- Fourcade L
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- Fozard T
- Fozard T
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- Francois-Coridon H
- Francone E
- Freitas Av
- Frey D
- Frisk B
- Fuentes-Rivera L
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- Gad A
- Gad Mo
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- Gaiž
- Gaignard E
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- Gamil D
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- Gani Ma
- Garaycochea O
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- Gerosa A
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- Geuoshy A
- Ghaben A
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- Guevara R
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- Gulielmi A
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- Halhouli O
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- Halicioglu I
- Hall E
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- Hamarshi A
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- Hasheminia A
- Hashim A
- Hashish A
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- Haslegrave A
- Hasnan Mb
- Hassaan A
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- Hassan Ata
- Hassan I
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- Hassan Z
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- Hassanein Ab
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- Huwait A
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- Iannone I
- Ibraheem Aa
- Ibraheem Hi
- Ibrahem Aa
- Ibrahem Aa
- Ibrahim A
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- Ibrahim Am
- Ibrahim E
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- Ibrahim I
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- Ibrahim M
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- Iftikhar Z
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- Ihediwa G
- Imoro O
- Ingabire Jca
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- Ioannidis O
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- Kamarulzamil Sna
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- Kasputyte S
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- Komolafe O
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- Kostov E
- Kotb Ahe
- Kotecha D
- Koto Mz
- Kotobi H
- Koumpa F
- Kouraklis G
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- Lawther R
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- Lee C
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- Leone N
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- Leusink A
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- Loaloa Mr
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- Machaca M
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- Marshall Dc
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- Mohamed F
- Mohamed I
- Mohamed M
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- Mohamed Maeh
- Mohamed Mm
- Mohamed O
- Mohamed Sr
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- Monteleone M
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- Montes I
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- Montrimaite M
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- Moodley Y
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- Mostafa M
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- Mshelbwala P
- Msiska N
- Msosa V
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- Nanthakumaran S
- Napolitano L
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- Naranjo Aristizã
- Narayanan R
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- Negida A
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- Nepogodiev D
- Nepogodiev D
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- Nesaratnam A
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- Nevieraite V
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- Ng S
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- Njokanma I
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- Nouh T
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- Novak A
- Nowers J
- Nsengimana Vjp
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- Ntirenganya F
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- Publication venue
- 'Wiley'
- Publication date
- 27/11/2018
- Field of study
Background
End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection.
Methods
This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model.
Results
In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001).
Conclusion
Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
Gender Difference in Teachers' Mathematical Knowledge for Teaching in the Context of Single-Sex Classrooms
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 10/03/2015
- Field of study
This study examines gender differences of teachers on their mathematical knowledge for teaching in the context of single-sex classrooms in Saudi Arabia. A translated version of the Mathematical Knowledge for Teaching (MKT) instrument (Learning Mathematics for Teaching [LMT], 2008) in Number and Operation Content Knowledge (CK) and Knowledge of Content and Student (KCS) scales were administered to 197 teachers (146 male and 51 female). Two-sample t test and multiple regression were conducted to compare the two groups and test the effect of teacher background variables. Female teachers significantly scored better than their male counterpart. Gender, years of teaching experience, and specialization significantly predicted teachers’ content knowledge, F(3, 187) = 13.180, explaining 41.8 % of the variance. Only gender and specialization significantly predicted teachers’ knowledge of content and student, F(2, 191) = 6.335, explaining 24.9 % of the variance. Further comparing items in the MKT instrument where female teachers outperformed male teachers confirmed that female teachers were better in attending to the content knowledge in the context of student’s learning.Scopu
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
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- 'Wiley'
- Publication date
- 01/01/2019
- Field of study
Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 percent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
Determinants of morbidity and mortality following emergency abdominal surgery in children in lowincome and middle-income countries
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- Publication venue
- 'BMJ'
- Publication date
- 01/01/2016
- Field of study
Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resourcepoor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally. Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression. Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed. Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- Author
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- Abbas M
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- Abd El Galeel A
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- Abd El Slam M
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- Abd Elrasoul Y
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- Abdelghany S
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- Zimmermann EF
- Zuber M
- Publication venue
- 'BMJ'
- Publication date
- 01/01/2016
- Field of study
Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally. Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression. Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed. Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas