Lectura de contexto y abordaje psicosocial desde los enfoques narrativos Dosquebradas.

Se profundiza en el estudio de casos de violencia y cómo estos afectan la subjetividad del individuo aflorando su capacidad de reponerse frente a estas situaciones de estrés en tales panoramas de desplazamiento forzado, por tal razón hay un aprendizaje individual y luego este aprendizaje se extrapola al trabajo colaborativo, donde también convergen las subjetividades de cada uno de los integrantes del grupo 442006A_108.It is deepened in the study of cases of violence and how they affect the subjectivity of the individual outlining their ability to recover from these situations of stress in such forced displacement scenarios, for that reason there is an individual learning and then this learning is extrapolated to work collaborative, where the subjectivities of each of the members of group 442006A_108 also converg

Riesgos del Emprendedor

ColcienciasUniversidad EAFIT - Departamento de Contaduría Pública. Semillero de Investigación en Control, Auditoría y Riesgos (SICAR)p. 9

Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery – a prospective cohort studyResearch in context

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017