19 research outputs found
Noise-induced hearing loss and hearing conservation in the iron and steel industry in South Africa
- Publication venue
- South African Society of Occupational Medicine (SASOM)
- Publication date
- 01/11/2014
- Field of study
BACKGROUND AND PURPOSE: The iron and steel industry in South Africa has been identified as one of the highest
risk industries in terms of noise induced hearing loss (NIHL). The National Institute for Occupational Health was
commissioned by the Department of Labour to audit the current noise exposure levels and hearing conservation
practices in eight major producers of iron and steel, and to make recommendations regarding prevention
strategies.
METHODS: The audit was conducted in two parts: the noise exposure levels and hearing conservation practices
were assessed by the occupational hygiene department. The occupational medicine department assessed the
hearing conservation policies and procedures, reviewed employees’ medical records to ascertain the number of
NIHL cases, and conducted verification of audiograms on a sample of employees working in noise zones.
RESULTS: Area noise levels exceeding 105 dB(A) were measured in four of the eight workplaces. The estimated
average annual incidence of NIHL varied from 0.7 - 8.3/1000/year. All companies did baseline, periodic and exit
audiometric testing, but there were notable discrepancies between companies and verification audiograms and
differences of more than 20 dB(A) were found. Although information and training on noise was reportedly done
in all worksites, a high proportion of workers could not demonstrate correct fitting of hearing protection devices
or recall when last they were trained.
CONCLUSION: A detailed standard operating procedure should be implemented for medical surveillance for NIHL
with action timelines that initiate remedial processes prior to employee developing compensable disease.
Aggregated audiometric testing results should be communicated to managers and health and safety teams to
provide guidance to prioritise areas for control measures. A quality assurance programme for audiometric
testing must be implemented. An evaluation tool to measure the effectiveness of the noise and hearing
conservation training provided to employees, including contracted employees, should be adopted.http://www.occhealth.co.zaam201
Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdollahi Arash
- Abdullahi Auwal
- Abegaz Kedir Hussein
- Abeldaño Zuñiga Roberto Ariel
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abreu Lucas Guimarães
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abualruz Hasan
- Ackerman Ilana N
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adebiyi Akindele Olupelumi
- Adepoju Abiola Victor
- Adewuyi Habeeb Omoponle
- Afyouni Shadi
- Afzal Saira
- Afzal Sina
- Agodi Antonella
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Shahzaib
- Ahmed Ali
- Ahmed Luai A
- Ahmed Muktar Beshir
- Ajami Marjan
- Akinosoglou Karolina
- Akkaif Mohammed Ahmed
- Al Hasan Syed Mahfuz
- Al-Aly Ziyad
- Al-Gheethi Adel Ali Saeed
- Al-Marwani Sabah
- Al-Omari Basem
- Al-Wardat Mohammad Sami
- Al-Worafi Yaser Mohammed
- Alalalmeh Samer O
- Albashtawy Mohammed
- Aldridge Robert W
- Alemu Meseret Desalegn
- Alemu Yihun Mulugeta
- Alene Kefyalew Addis
- Alharrasi Maryam
- Alhassan Robert Kaba
- Ali Mohammed Usman
- Ali Rafat
- Ali Syed Shujait Shujait
- Alif Sheikh Mohammad
- Aljunid Syed Mohamed
- Almazan Joseph Uy
- Alomari Mahmoud A
- Altaany Zaid
- Alvis-Guzman Nelson
- Alvis-Zakzuk Nelson J
- Alwafi Hassan
- Aly Safwat
- Alzoubi Karem H
- Amare Azmeraw T
- Amegbor Prince M
- Ameyaw Edward Kwabena
- Amin Tarek Tawfik
- Amindarolzarbi Alireza
- Amiri Sohrab
- Amugsi Dickson A
- Ancuceanu Robert
- Anderlini Deanna
- Anderson David B
- Andrade Pedro Prata
- Andrei Catalina Liliana
- Ansari Hossein
- Antony Catherine M
- Anwar Saleha
- Anwar Sumadi Lukman
- Anwer Razique
- Anyanwu Philip Emeka
- Arab Juan Pablo
- Arabloo Jalal
- Arafat Mosab
- Araki Daniel T
- Aravkin Aleksandr Y
- Arkew Mesay
- Armocida Benedetta
- Arndt Michael Benjamin
- Arooj Mahwish
- Artamonov Anton A
- Aruleba Raphael Taiwo
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- Badar Muhammad
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- Weaver Marcia R
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- Wu Chenkai
- Wu Felicia
- Wu Xinsheng
- Wu Zenghong
- Wulf Hanson Sarah
- Xia Yanjie
- Xiao Hong
- Xu Xiaoyue
- Xu Yvonne Yiru
- Yadav Lalit
- Yadollahpour Ali
- Yaghoubi Sajad
- Yamagishi Kazumasa
- Yang Lin
- Yano Yuichiro
- Yao Yao
- Yaribeygi Habib
- Yazdanpanah Mohammad Hosein
- Ye Pengpeng
- Yehualashet Sisay Shewasinad
- Yesuf Subah Abderehim
- Yezli Saber
- Yigzaw Zeamanuel Anteneh
- Yiğit Arzu
- Yiğit Vahit
- Yismaw Yazachew
- Yon Dong Keon
- Yonemoto Naohiro
- Younis Mustafa Z
- Yu Chuanhua
- Yu Yong
- Yusuf Hadiza
- Zahid Mondal Hasan
- Zakham Fathiah
- Zaki Leila
- Zaki Nazar
- Zaman Burhan Abdullah
- Zamora Nelson
- Zand Ramin
- Zandieh Ghazal G Z
- Zar Heather J
- Zarrintan Armin
- Zastrozhin Mikhail Sergeevich
- Zhang Haijun
- Zhang Ning
- Zhang Yunquan
- Zhao Hanqing
- Zhong Chenwen
- Zhong Panliang
- Zhou Juexiao
- Zhu Zhaohua
- Ziafati Makan
- Zielińska Magdalena
- Zimsen Stephanie R M
- Zoladl Mohammad
- Zumla Alimuddin
- Zyoud Samer H
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation
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Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Ababneh Hazim S
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbasgholizadeh Rouzbeh
- Abbasi-Kangevari Mohsen
- Abbasian Mohammadreza
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdelwahab Ahmed
- Abdollahi Mohammad
- Abdollahifar Mohammad-Amin
- Abdoun Meriem
- Abdulah Deldar Morad
- Abdullahi Auwal
- Abebe Mesfin
- Abebe Samrawit Shawel
- Abedi Aidin
- Abegaz Kedir Hussein
- Abhilash E S
- Abidi Hassan
- Abiodun Olumide
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abolmaali Meysam
- Abouzid Mohamed
- Aboye Girma Beressa
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abtahi Dariush
- Abu Rumeileh Samir
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abu-Zaid Ahmed
- Abualruz Hasan
- Abubakar Bilyaminu
- Aburuz Salahdein
- Accrombessi Manfred Mario Kokou
- Adal Tadele Girum
- Adamu Abdu A
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adebiyi Akindele Olupelumi
- Adekanmbi Victor
- Adepoju Abiola Victor
- Adetunji Charles Oluwaseun
- Adetunji Juliana Bunmi
- Adeyeoluwa Temitayo Esther
- Adeyinka Daniel Adedayo
- Adeyomoye Olorunsola Israel
- Admass Biruk Adie Adie
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afolabi Aanuoluwapo Adeyimika
- Afzal Muhammad Sohail
- Afzal Saira
- Agampodi Suneth Buddhika
- Agasthi Pradyumna
- Aggarwal Manik
- Aghamiri Shahin
- Agide Feleke Doyore
- Agodi Antonella
- Agrawal Anurag
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Muayyad M
- Ahmad Sajjad
- Ahmad Shahzaib
- Ahmad Tauseef
- Ahmadi Keivan
- Ahmadzade Amir Mahmoud
- Ahmed Ali
- Ahmed Ayman
- Ahmed Haroon
- Ahmed Luai A
- Ahmed Mehrunnisha Sharif
- Ahmed Meqdad Saleh
- Ahmed Muktar Beshir
- Ahmed Syed Anees
- Ajami Marjan
- Aji Budi
- Akara Essona Matatom
- Akbarialiabad Hossein
- Akinosoglou Karolina
- Akinyemiju Tomi
- Akkaif Mohammed Ahmed
- Akyirem Samuel
- Al Hamad Hanadi
- Al Hasan Syed Mahfuz
- Al-Aly Ziyad
- Al-amer Rasmieh Mustafa
- Al-Azzam Sayer
- Al-Gheethi Adel Ali Saeed
- Al-Hanawi Mohammed Khaled
- Al-Marwani Sabah
- Al-Maweri Sadeq Ali Ali
- Al-Mekhlafi Hesham M
- Al-Omari Basem
- Al-Sabah Salman Khalifah
- Al-Tawfiq Jaffar A
- Al-Worafi Yaser Mohammed
- Alahdab Fares
- Alalalmeh Samer O
- Alalwan Tariq A
- Alam Khurshid
- Alam Manjurul
- Alam Noore
- Alanezi Fahad Mashhour
- Alanzi Turki M
- Albakri Almaza
- Albashtawy Mohammed
- AlBataineh Mohammad T
- Alcalde-Rabanal Jacqueline Elizabeth
- Aldawsari Khalifah A
- Aldhaleei Wafa A
- Aldridge Robert W
- Alema Haileselasie Berhane
- Alemayohu Mulubirhan Assefa
- Alemi Sharifullah
- Alemu Yihun Mulugeta
- Alhabib Khalid F
- Alhalaiqa Fadwa Alhalaiqa Naji
- Ali Abid
- Ali Amjad
- Ali Liaqat
- Ali Mohammed Usman
- Ali Rafat
- Ali Shahid
- Ali Syed Shujait Shujait
- Alicandro Gianfranco
- Alif Sheikh Mohammad
- Alikhani Reyhaneh
- Alimohamadi Yousef
- Aliyi Ahmednur Adem
- Aljasir Mohammad A M
- Aljunid Syed Mohamed
- Alla François
- Allebeck Peter
- Almazan Joseph Uy
- Almidani Louay
- Almidani Omar
- Alomari Mahmoud A
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- Alqahtani Jaber S
- Alqalyoobi Shehabaldin
- Alqutaibi Ahmed Yaseen
- Altaany Zaid
- Altaf Awais
- Altirkawi Khalid A
- Aluh Deborah Oyine
- Alvis-Guzman Nelson
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- Aly Safwat
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- Amani Reza
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- Amegbor Prince M
- Ameyaw Edward Kwabena
- Amin Tarek Tawfik
- Amindarolzarbi Alireza
- Amiri Sohrab
- Amirzade-Iranaq Mohammad Hosein
- Amu Hubert
- Amugsi Dickson A
- Amusa Ganiyu Adeniyi
- Ancuceanu Robert
- Anderlini Deanna
- Anderson David B
- Andrade Pedro Prata
- Andrei Catalina Liliana
- Andrei Tudorel
- Angus Colin
- Anil Abhishek
- Anil Sneha
- Anoushiravani Amir
- Ansari Hossein
- Ansari-Moghaddam Alireza
- Ansariadi Ansariadi
- Antony Catherine M
- Antriyandarti Ernoiz
- Anvari Davood
- Anvari Saeid
- Anwar Saleha
- Anwar Sumadi Lukman
- Anwer Razique
- Anyasodor Anayochukwu Edward
- Aqeel Muhammad
- Arab Juan Pablo
- Arabloo Jalal
- Arafat Mosab
- Aravkin Aleksandr Y
- Areda Demelash
- Aremu Abdulfatai
- Aremu Olatunde
- Ariffin Hany
- Arkew Mesay
- Armocida Benedetta
- Arndt Michael Benjamin
- Arooj Mahwish
- Artamonov Anton A
- Arulappan Judie
- Aruleba Raphael Taiwo
- Arumugam Ashokan
- Asaad Malke
- Asadi-Lari Mohsen
- Asgedom Akeza Awealom
- Asghari-Jafarabadi Mohammad
- Asghariahmadabad Mona
- Ashraf Muhammad
- Aslani Armin
- Astell-Burt Thomas
- Athar Mohammad
- Athari Seyyed Shamsadin
- Atinafu Bantalem Tilaye Tilaye
- Atlaw Habtamu Wondmagegn
- Atorkey Prince
- Atout Maha Moh'd Wahbi
- Atreya Alok
- Aujayeb Avinash
- Ausloos Marcel
- Avan Abolfazl
- Awedew Atalel Fentahun
- Aweke Amlaku Mulat
- Ayala Quintanilla Beatriz Paulina
- Ayatollahi Haleh
- Ayuso-Mateos Jose L
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- Bako Abdulaziz T
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- Bandyopadhyay Soham
- Banik Palash Chandra
- Bansal Hansi
- Bansal Kannu
- Barbic Franca
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- Bardhan Mainak
- Bardideh Erfan
- Barker-Collo Suzanne Lyn
- Barone-Adesi Francesco
- Barqawi Hiba Jawdat
- Barrero Lope H
- Barrow Amadou
- Barteit Sandra
- Barua Lingkan
- Basharat Zarrin
- Bashiri Azadeh
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- Xu Suowen
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- Xu Xiaoyue
- Xu Yvonne Yiru
- Yadollahpour Ali
- Yamagishi Kazumasa
- Yang Danting
- Yang Lin
- Yano Yuichiro
- Yao Yao
- Yaribeygi Habib
- Ye Pengpeng
- Yehualashet Sisay Shewasinad
- Yesiltepe Metin
- Yesuf Subah Abderehim
- Yezli Saber
- Yi Siyan
- Yigezu Amanuel
- Yip Paul
- Yismaw Malede Berihun
- Yismaw Yazachew
- Yiğit Arzu
- Yiğit Vahit
- Yon Dong Keon
- Yonemoto Naohiro
- Yoon Seok-Jun
- You Yuyi
- Younis Mustafa Z
- Yousefi Zabihollah
- Yu Chuanhua
- Yu Yong
- Yuh Faith H
- Zadey Siddhesh
- Zadnik Vesna
- Zafari Nima
- Zakham Fathiah
- Zaki Nazar
- Zaman Sojib Bin
- Zamora Nelson
- Zand Ramin
- Zangiabadian Moein
- Zar Heather J
- Zare Iman
- Zarrintan Armin
- Zeariya Mohammed G M
- Zeinali Zahra
- Zhang Haijun
- Zhang Jianrong
- Zhang Jingya
- Zhang Liqun
- Zhang Yunquan
- Zhang Zhi-Jiang
- Zhao Hanqing
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Lei
- Ziafati Makan
- Zielińska Magdalena
- Zitoun Osama A
- Zoladl Mohammad
- Zou Zhiyong
- Zuhlke Liesl J
- Zumla Alimuddin
- Zweck Elric
- Zyoud Samer H
- Ärnlöv Johan
- Šekerija Mario
- Publication venue
- Elsevier
- Publication date
- 01/01/2024
- Field of study
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
Safety of hospital discharge before return of bowel function after elective colorectal surgery
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- Zulkefley N.
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2020
- Field of study
Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients
Safety of hospital discharge before return of bowel function after elective colorectal surgery
- Author
- Aabling R R
- Aba M
- Abad-Motos A
- Abbasguliyev H
- Abdelgalil R
- Abdelhameed F
- Abdulrahman N
- Abdulrahman S M F
- Abdulrahman Z
- Abelevich A
- Abelló D
- Ablett A D
- Ablett A D
- Abrisqueta J
- Acherman Y I Z
- Adam A H
- Adamo V
- Adams S I B
- Adel A
- Adeleye O
- Adeusi L
- Adra M
- Aftab R
- Agarwal A
- Agarwal T
- Agca M H
- Aggiusti A
- Agresta F
- Aguilar J F Noguera
- Aguilar-Martínez M M
- Aguilera M L
- Aguilera M L
- Aguilera M L
- Ahmad H
- Ahmed A
- Ahmed H
- Ahmed K
- Ahmed M
- Ahmed M
- Ahmed S
- Ahmed W U R
- Ahmeidat A
- Ahsan S D
- Ainsworth P
- Aitken G
- Ajmera A
- Akay F E
- Akbani U
- Akbar Z
- Akbari K
- Akbari K
- Akhbari M
- Akın F A
- Akisheva A
- Akram B
- Aksoy A B
- Aksoy B
- Aksoy H
- Aktas M K
- Aktas M K
- Aktas M K
- Aktuna C
- Akyol C
- Al Zawawi S
- Al-Azzawi A
- Al-hadithi A
- Al-Salihi A
- Al-Saraff Z
- Al-Sarraf Z
- Alame Y J
- Alasmar M
- Alawattegama H
- Albayrak D
- Alberca-Paramo A
- Albert V
- Alconchel F
- Aldarragi A
- Alexander J
- Alhalabi O
- Ali A
- Ali A
- Ali Y
- Ali Z
- Alim Y E
- Aliosin O
- Aljohmani L
- Allen B
- Allen M
- Alm J
- Almeida J
- Almeida null
- Almeida P
- Almeida S
- Alonso B Campillo
- Alonso E Diego
- Alonso-Poza A
- Alqethami H J
- Alsaif A
- Alshakhs A
- Altiner S
- Altintas E
- Altomare D F
- Alvarez E
- Alvarez M Merayo
- Alves D
- Alves M
- Alves-Vale C
- Aly M H
- Amado A
- Amado F
- Amarnath T
- Amato R
- Ambrona-Zafra D
- Americano M
- Amey C
- Amico A
- Amicucci S
- Amini S
- Amiri S
- Amjad T
- Amor L González
- Amorim E
- Amorim E
- Anania G
- Anania M
- Anastasio L
- Anbarasan J
- Ancans G
- Anderson L
- Andolfi E
- Andrés C Blasco
- Andriola V
- Angeles P Vivas
- Angelini M
- Angelucci G P
- Angrisani M
- Anoldo P
- Antakia R
- Anthony-Uzoeto U
- Antona A D
- Antona F Blanco
- Antonakopoulos F
- Antonova T
- Antunes C Fidalgo
- Anwar H
- Aparício D J
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- Appleby E
- Aquilino F
- Archer J
- Aresu S
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- Argenti A Sgrò F
- Arias-Camisón P Livianos
- Arkadopoulos N
- Armellini A
- Arnold A
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- Arranz J M Nieto
- Arrocha J Duran
- Arroyo A
- Arslan E
- Arthur J
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- Artioli E
- Aru A C
- Ashworth I
- Ashworth I
- Asif A
- Asif A
- Atar C
- Athanasopoulos P G
- Atiyah A
- Attene F
- Aveiro D
- Avelino L
- Avendaño I Esteban
- Aversano A
- Awokoya O
- Aydin T
- Aykun N
- Ayllon H
- Aytin Y E
- Ayyar S
- Azevedo J
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- Bacchion M
- Badhrinarayanan S
- Badran A
- Badran A
- Baggus E
- Bagnall M
- Baião J M
- Baird J
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- Balalis D
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- Baldassarre L
- Balestra F
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- Ballarini Z
- Balsamo F
- Banaz T
- Bandyopadhyay D
- Bansal N
- Baraghini M
- Baran T
- Barbadillo A Trujillo
- Barberis A
- Barbosa E
- Bareh A
- Barina A
- Barkolias C
- Barkovskaya A
- Barnett R
- Baronio G
- Barrett A
- Bartnick A
- Bartoli A
- Bartoš M
- Basak A
- Basile E
- Basile R
- Basso S
- Başçavuş M
- Batanero E Alonso
- Bate R
- Bath M F
- Bath M F
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- Batterham A
- Bautista O Anabitarte
- Bautista O Anabitarte
- Bautista O Anabitarte
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- Bártolo J
- Beattie G
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- Belia F
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- Bellmunt O Claramonte
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- Bellochi R
- Belluco C
- Belzunce-Capó J F
- Bemelman W A
- Benevento A
- Benli G E
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- Benvenuto D
- Beqiri S
- Berec S
- Bergara I Badiola
- Bergkvist D Julià
- Bernado I R
- Bernardes T C Sá F M
- Berry B
- Berti S
- Bertilone E
- Betancourth C F Campo
- Betge F
- Bettella A
- Bettencourt R
- Bevilacqua E
- Bevilacqua M
- Bhahirathan Y
- Bhahirathan Y
- Bhargava A
- Bharwada Y
- Bhatia S
- Bholah H
- Bhopal S
- Biancafarina A
- Biancafarina A
- Bianchi C
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- Bianco C
- Bilen C
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- Bilicen G
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- Binbuga M
- Bini R
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- Birindelli A
- Birindelli A
- Birk J
- Bisagni P A G
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- Bissett I P
- Bitonti M F
- Biyiklioglu O
- Bjerke J
- Blackwood O
- Blanco-Colino R
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- Blanco-Colino R
- Blaser B
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- Blefari N D A
- Bloom I
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- Boersma D
- Boev B
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- Bondurri A
- Bonfante P
- Bonnet G
- Boon C L
- Borakati A
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- Borg C M
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- Borges F
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- Borisova A
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- Borrow J L
- Bosch M
- Botelho C
- Botelho P
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- Bowers C
- Bowley D
- Bowman C
- Boyce L
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- Boys M Hardie
- Boztuğ C Y
- Braccio B
- Bradbury M
- Bradley E
- Brady R
- Brandao B D
- Brandsborg S
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- Brandsma A M
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- Brenna R
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- Brown S
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- Bucci A Fares
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- Buckland B
- Bugelli M
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- Butt S
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- Calgaro M
- Calle M Pérez
- Calussi M
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- Campagnaro T
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- Campanaro C
- Campanella S
- Campbell A
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- Campos M Sequeira
- Campos P Villarejo
- Camprubí E Alberch
- Can B
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- Canonico G
- Canonico G
- Canotilho R
- Cantafio S
- Cañete-Gómez J
- Cañete-Manzanares J
- Capella V
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- Capote H
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- Cappellacci F
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- Carden C
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- Cassar J
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- Ceccarelli G
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- Cefai C
- Celik M
- Cengiz U
- Centeno A
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- Chaudhry F A
- Chaudhury N
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- Chee S Y
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- Christodoulou I M
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- Christodoulou T
- Christy S
- Chrysoheris P
- Chrz K
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- Chu M
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- Chuang A
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- Ciccioli E
- Cigognini M
- Cillara N
- Cinar E N
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- Cinza A M
- Cirillo B
- Cismasiu B
- Ciubotaru C
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- Ciurleo C
- Claassen L
- Claireaux H
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- Clarke R
- Claro M
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- Clerc D
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- Coletta D
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- Constansia R
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- Cross G W V
- Cruccu A
- Cruz A
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- Cuartango A Sagredo
- Cucinotta E
- Cuello E
- Cuicchi D
- Cuming T
- Cunha C
- Cunha M
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- Cunha P
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- Curletti G
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- Ćuk V V
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- Çetin M F
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- D'Errico U
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- da Ponte I Borges
- da Silva B Ribeiro
- Dabab N
- Dahya D
- Dalsgaard P
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- Dalzell F
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- Dansuk S
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- De Angelis M
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- de Gouberville M C Gordinou
- De Jesus M
- de la Cruz G
- De Lima H
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- De Luca E
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- de Manzoni Garberini A
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- De Marco P
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- De Nisco C
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- De Padua C
- De Palma G
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- de Quirós J T Morales Bernaldo
- De Rosa M
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- de Roy van Zuidewijn D
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- Debiasio A
- Debono S
- Defriend D
- Degaetano D
- Deksnis D
- Del Basso C
- del Pozo Andrés E
- del Pulgar A Gómez
- Delaugere L P
- Delgado P Alberti
- Delibegovic S
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- Delibegovic S
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- Delorme M
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- Demiroglu Y
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- Di Candido F
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- Di Marco F
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- Diago J Platero
- Diallo R
- Dias B
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- Dimitrov D
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- Dingemans S A
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- Duchalais E
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- Dulskas A
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- Dunmore C
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- Dwyer-Hemmings L
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- Eames S
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- Ehlern F
- Eiró F
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- Eismontas V
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- El Kasmi Y El Kasmy
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- Esposito L M
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- Fadipe T
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- Farina V
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- Farrow F
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- Federico N S Pipitone
- Federico N S Pipitone
- Feleppa C
- Felipe B Ricardo
- Feliz J Medina
- Fenn S
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- Fernandes V
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- Francisco V
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- Ibrahim B
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- Idoate C Pastor
- Ike S I
- Iliev S
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- Illahi M
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- Imadalou L
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- Impellizzeri H
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- Imperatore M
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- Ioannidis A
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- Iqbal R
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- Irwin E
- Isabello A
- Isik A
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- Isler V C
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- Ivanov T
- Ivanov V
- Ivanov V
- Izzarina A
- İşlek E C
- Jackson A
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- Jacobson A
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- Jaich R
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- Jain A
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- Shrestha S
- Sierra J E
- Silva A
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- Silva F Brito
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- Simcikas D
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- Simioni A
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- Sinibaldi G
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- Sinovas O Esteban
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- Siva S
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- Sivinš A
- Skalický A
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- Suchdev N
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- Suchett-Kaye I
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- Tabibi M
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- Talamo G
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- Tamini N
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- Tamosiunas A
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- Tan I X H
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- Tasdelen I
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- Teeling F
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- Teixeira H
- Telford K
- ten Doesschate S F H
- ten Doesschate S F H
- Tenconi S M
- Terricabras S Rifà
- Testa V
- Testa V
- Tew Z Yi
- Tew Z Yi
- Tewhaiti-Smith J
- Thakkar R
- Thakral N
- Thakrar C
- Thakrar C
- Thakrar V
- Thavayogan R
- Thavayogan R
- Thãwel T
- Theocharidou L
- Theodoraki G
- Theodoropoulou K
- Thirugnanasundralingam V
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- Tiftik E
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- Tilocca P L
- Timms S
- Tınaz A
- Tincknell L
- Tipi O U
- Tirelli F
- Tirelli F
- Tirotta F
- Tissen Y M
- Tissink M W
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- Toh C
- Toh C
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- Torrance A
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- Xiao Y
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- Yanishev A
- Yanishev A
- Yanishev A
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- Yasin I H
- Yasin I H
- Yassaie S
- Yassaie S S
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- Yavuz G
- Yeap B
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- Yebes A
- Yelkenci C
- Yeni M
- Yeo Y Q
- Yeoh T
- Yesilsancak M
- Yildirak M K
- Yildirim N
- Yilmaz D
- Yilmaz D
- Yilmaz I
- Yılmaz M
- Yilmaz S
- Yiu J
- Yong S Q
- Yoong A
- Yotsov T
- Young J
- Youssef H
- Youssef Y
- Yu N
- Yuksek A
- Yumurtaci Ö
- Yurdaor S S
- Yurdaor S S
- Yusuf Z
- Yüksek B
- Yüksek B
- Zaffaroni G
- Zaidi A
- Zalla T
- Zaman S
- Zamzow K
- Zardab M
- Zearmal S
- Zeb E
- Zegarra E D Padilla
- Zeromskas P
- Zeynalov F
- Zhao J
- Zhao S
- Zheng S
- Zhu L Y
- Zoikas A
- Zoikas A
- Zubowicz M
- Zuin M
- Zulkefley N
- Žebrák M Farkašová R
- Žebrák R
- Publication venue
- Publication date
- 01/01/2020
- Field of study
Background Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system. Results A total of 3288 patients were included in the analysis, of whom 301 (9 center dot 2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0 center dot 001). There were no significant differences in rates of readmission between these groups (6 center dot 6 versus 8 center dot 0 per cent; P = 0 center dot 499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0 center dot 90, 95 per cent c.i. 0 center dot 55 to 1 center dot 46; P = 0 center dot 659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34 center dot 7 versus 39 center dot 5 per cent; major 3 center dot 3 versus 3 center dot 4 per cent; P = 0 center dot 110). Conclusion Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients
Safety of hospital discharge before return of bowel function after elective colorectal surgery
- Author
- A A Francis
- A A Francis
- A Abad-Motos
- A Abelevich
- A Adel
- A Agarwal
- A Aggiusti
- A Ahmed
- A Ahmeidat
- A Ajmera
- A Akisheva
- A Al-Azzawi
- A Al-Hadithi
- A Al-Salihi
- A Alagoa João
- A Alagoa João
- A Alberca-Paramo
- A Aldarragi
- A Ali
- A Ali
- A Alonso-Poza
- A Alsaif
- A Alshakhs
- A Amado
- A Amico
- A Armellini
- A Arnold
- A Arroyo
- A Asif
- A Asif
- A Atiyah
- A Aversano
- A B Aksoy
- A B Teasdale
- A Badran
- A Badran
- A Barberis
- A Bareh
- A Barina
- A Barkovskaya
- A Barrett
- A Bartnick
- A Bartoli
- A Basak
- A Batista
- A Batterham
- A Begaj
- A Belli
- A Belli
- A Benevento
- A Bettella
- A Bhargava
- A Biancafarina
- A Biancafarina
- A Birindelli
- A Birindelli
- A Bondurri
- A Borakati
- A Borakati
- A Bordanova Reverter
- A Borisova
- A Borisova
- A Boulbadaoui
- A Brescia
- A Brodie
- A Bugmann
- A Burzic
- A Busuttil
- A C Aru
- A C Bilgili
- A C Pedersen
- A C Quintela
- A Caiazzo
- A Campbell
- A Campbell
- A Campbell
- A Capozzolo
- A Casaril
- A Castro
- A Centeno
- A Chan
- A Charalabopoulos
- A Charalambous
- A Chiang
- A Chrimes
- A Chuang
- A Clavé Llavall
- A Clucas
- A Coomes
- A Couldrey
- A Craus-Miguel
- A Cruccu
- A Cruz
- A Cuenca Ramírez
- A Cutler
- A D Ablett
- A D Ablett
- A D Antona
- A D Cevlik
- A Dawson
- A Dawson
- A De La Llave Serralvo
- A de Manzoni Garberini
- A de Manzoni Garberini
- A de Ruiter
- A Debiasio
- A Dharni
- A Di Cintio
- A Dias Matos
- A Drane
- A Dulskas
- A Dworkin
- A Díaz Padillo
- A E Isik
- A Elbayouk
- A Emin
- A Espí Macías
- A F Rocha
- A Fares Bucci
- A Faustino
- A Fernandez
- A Fontani
- A Forero-Torres
- A Forero-Torres
- A Forero-Torres
- A Foulkes
- A Franceschi
- A Franceschi
- A Fung
- A G Marrosu
- A G Silva
- A Gabarski
- A Gadhvi
- A Galgano
- A Garcea
- A Garcia
- A García-Vico
- A Gavrilina
- A Gemini
- A Gennai
- A Gharooni
- A Ghosh
- A Giani
- A Giannella
- A Gibbins
- A Gil
- A Gil-Catalán
- A Gilliam
- A Giri
- A Goede
- A Gopaul
- A Gordon
- A Gori
- A Grüter
- A Guerreiro
- A Guglielmi
- A Guner
- A Gómez Del Pulgar
- A Güldag
- A H Adam
- A H Dyer
- A Haji
- A Henkens
- A Herd
- A Heybourne
- A Hickman
- A Hogan
- A Hogan
- A Hotchkies
- A Huot
- A Hylands
- A I Pinillos
- A Ibrahim
- A Ioannidis
- A Ioannidis
- A Ipor
- A Isabello
- A Isik
- A Izquierdo Moreno
- A Izzarina
- A Jackson
- A Jacobson
- A Jain
- A James
- A Jones
- A Joseph
- A Jovaisaite
- A K Aly
- A Kanitkar
- A Karabulut
- A Kechagias
- A Kechagias
- A Kechagias
- A Kefleyesus
- A Kelliher
- A Khan
- A Khanan Kaabneh
- A Kilinç
- A Kisiel
- A Kisiel
- A Kler
- A Kopp
- A Kumar
- A Kurt
- A Kushairi
- A L Mihaljevic
- A Landaluce Olavarria
- A Laranjeira
- A Larcinese
- A Lauretta
- A Lauretta
- A Litvin
- A Litvin
- A Lo Conte
- A Loizidou
- A Longheu
- A Longshaw
- A Lorettu
- A Lucchi
- A Lucchi
- A M Brandsma
- A M Cinza
- A M Correia
- A M Estévez Diz
- A M Pektas
- A M Seckler
- A M Wiemann
- A Machado
- A Madhavan
- A Maffioli
- A Magri Piccinini
- A Mahmoud
- A Mandal
- A Manso
- A Marano
- A Marcos Rodrigo
- A Margarida
- A Mark-Christensen
- A Mark-Christensen
- A Maroli
- A Martensen
- A Martinez
- A Mathioulaki
- A McTighe
- A Mereu
- A Midgen
- A Millward
- A Mitra
- A Mondal
- A Mondal
- A Moosa
- A Mora
- A Morris
- A Mukkavilli
- A Nair
- A Navío
- A Nayeem
- A Neilson
- A Newton
- A Nicolaides
- A Nirmalanantha
- A Nur
- A O Sunay
- A O'Neill
- A Ojakäär
- A Ong
- A Otto
- A Otto
- A Ozolins
- A P Torre
- A Pacheco
- A Paclík
- A Palkhi
- A Palmer
- A Pandya
- A Panyko
- A Paolucci
- A Papanikolaou
- A Parisi
- A Paspala
- A Percassi
- A Percivale
- A Pergel
- A Pesce
- A Picciariello
- A Picciariello
- A Pietrabissa
- A Pimentel
- A Piperidis
- A Poncelet
- A Portugal Martínez
- A Powell-Chandler
- A Powell-Chandler
- A Prodromidou
- A Pullybank
- A Pérez Ortega
- A Quevedo
- A R Loureiro
- A R Martins
- A R Pentony
- A Ragavoodoo
- A Ragavoodoo
- A Rahman
- A Rais
- A Ramdin
- A Ramjeeawon
- A Ramwell
- A Rankin
- A Rashid
- A Realis Luc
- A Reddy
- A Refalo
- A Rencuzogullari
- A Ribeiro
- A Rodríguez Sánchez
- A Roggiani
- A Roman-Rando
- A Ruggieri
- A Ruparelia
- A Ruzzenente
- A Rylance
- A S Ferreira
- A S Hussain
- A Saba
- A Sagnotta
- A Sagnotta
- A Sagredo Cuartango
- A Saha
- A Saiyed
- A Saiyed
- A Samee
- A Sangheli
- A Savchenko
- A Saxena
- A Schimera
- A Schizas
- A Scott
- A Semiz
- A Sgrò
- A Sgrò
- A Sgrò
- A Sgrò
- A Shashidhara
- A Silva
- A Silva
- A Simioni
- A Simioni
- A Simioni
- A Singh
- A Sivinš
- A Skalický
- A Skavysh
- A Skull
- A Slepavicius
- A Soares
- A Soares
- A Soma
- A Southgate
- A Sparke
- A Spaziani
- A Spinelli
- A Sunal
- A Sánchez López
- A Tamosiunas
- A Tang
- A Tınaz
- A Torrance
- A Trap
- A Trujillo Barbadillo
- A Truškovs
- A Tura
- A Turunen
- A Ucar
- A Unsworth
- A Uyanik
- A V Robinson
- A Vadillo-Bohorquez
- A van der Pool
- A Vanoni
- A Varghese
- A Vedadi
- A Venara
- A Vignali
- A Vucicevic
- A W Azhar
- A Walsh
- A Warsame
- A Wells
- A Wilkes
- A Yagız Sen
- A Yagız Sen
- A Yagız Sen
- A Yalcinkaya
- A Yanishev
- A Yanishev
- A Yanishev
- A Yebes
- A Yebes
- A Yoong
- A Yuksek
- A Z Sahin
- A Zaidi
- A Zoikas
- A Zoikas
- Aab Wyche
- Aaw van Geloven
- Ahw van de Ven
- Ashm van Dalen
- Ashm van Dalen
- Asi Hassane
- B A Perrone
- B Akram
- B Aksoy
- B Aksoy
- B Allen
- B B Ozkan
- B B Ozmen
- B Baljer
- B Baykan
- B Berry
- B Blaser
- B Blaser
- B Boev
- B Borghi
- B Braccio
- B Buckland
- B Campbell
- B Campillo Alonso
- B Can
- B Carhart
- B Castro
- B Chandrasekar
- B Chrisp
- B Cirillo
- B Cismasiu
- B Cresswell
- B D Brandao
- B Demirtas
- B Desmond
- B Dias
- B Dieguez
- B Djeugam
- B E Baki
- B E Baki
- B Ekci
- B Emiroglu
- B Fakim
- B Fanibi
- B Frezza
- B Gagliardi
- B Gagliardi
- B Gurung
- B Güner
- B Hardy
- B Ibrahim
- B J Finch
- B J Finch
- B Jenkins
- B Karip
- B Kelly
- B Kološová
- B Kulendrarajah
- B Kutlu
- B L van Leeuwen
- B Langenhoff
- B Liu
- B M Elliott
- B M Elliott
- B Mekaeil
- B Mikhail
- B Mollavelioglu
- B Molteni
- B Molteni
- B Mutlu
- B N Jepsen
- B N Vieira
- B N Vieira
- B Nasimi
- B Ng
- B Pando
- B Ribeiro da Silva
- B Ricardo Felipe
- B S Rocha
- B S Yilmaz
- B Shirazi
- B Shishkin
- B Singh
- B Smith
- B Soares
- B Stainer
- B Stanfield
- B Stubbs
- B Söyleyici
- B Thompson
- B Walters
- B Woodburn
- B Yeap
- B Yüksek
- B Yüksek
- Bpl Wijnhoven
- C Adiyaman
- C Aktuna
- C Akyol
- C Alves-Vale
- C Amey
- C Atar
- C Auty
- C B Recuenco
- C Barkolias
- C Belluco
- C Bianchi
- C Bianco
- C Bilen
- C Blasco Andrés
- C Botelho
- C Bowers
- C Bowman
- C Brigand
- C Burford
- C Bustamante Recuenco
- C C Lopes Moreira
- C C Lopes Moreira
- C Cabaleiro Barciela
- C Cachia
- C Campanaro
- C Campbell
- C Carden
- C Carey
- C Carneiro
- C Caula Freixa
- C Cefai
- C Cerdán
- C Cerra
- C Ceylan
- C Chipeta
- C Chong
- C Ciubotaru
- C Ciurleo
- C Codony Bassols
- C Conti
- C Corino
- C Costa
- C Costa
- C Coulter
- C Cunha
- C Curtis
- C D Brumfitt
- C D Brumfitt
- C D Roche
- C D Skejø
- C De Nisco
- C De Nisco
- C De Padua
- C Del Basso
- C Doherty
- C Donaldson
- C Donnelly
- C Dunmore
- C Dörr-Harim
- C Ede
- C English
- C Evans
- C F Campo Betancourth
- C Fairén Oro
- C Fairén Oro
- C Faqihinejad
- C Feleppa
- C Ferrari
- C Ferrari
- C Fidalgo Antunes
- C Fioriti
- C Foppa
- C Galata
- C Gallagher
- C Genzano
- C Gilsanz
- C Green
- C H Knowles
- C Haglund
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- C Harmston
- C Hensher
- C Hew
- C Hobson
- C Hoff
- C Horner
- C I Ciubotaru
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- C J Fairfield
- C Jain
- C James
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- C Jiménez Relimpio
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- C Kruger
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- C L Piong
- C Leavey
- C Lye
- C M Borg
- C M Cheong
- C M Ruddy
- C Macleod Hall
- C Maden
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- C Mason
- C Massaiu
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- C Maxwell-Armstrong
- C Mazzeo
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- C McClarty
- C McCusker
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- C Moehwald
- C Montalvo Olmedo
- C Monteiro
- C Monteiro
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- C Mulvenna
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- C Murphy
- C Nascimento
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- C Neves-Marques
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- C Olmedo Moreno
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- V Ozben
- V P Geneta
- V Paixão
- V Panizzo
- V Papagni
- V Patel
- V Pavlov
- V Pedro
- V Poponesi
- V Portugal Porras
- V Praxedes
- V Prochazka
- V Ripetti
- V Ripetti
- V Schaeff
- V Schaeff
- V Taranu
- V Testa
- V Testa
- V Thakrar
- V Thirugnanasundralingam
- V Tonini
- V Udayachandran
- V V Ćuk
- V V Ćuk
- V Vigorita
- V Vyas
- W A Bemelman
- W Beedham
- W Clay
- W Fleischl
- W Fordyce
- W Fradley
- W J English
- W J Owen
- W K Lau
- W Lam
- W Mculu
- W Perchard
- W Pyc
- W Pyc
- W Reynolds
- W S Ngu
- W Saleh
- W Simpson
- W Sloper
- W Sloper
- W Thomson
- W Wynell-Mayow
- Wur Ahmed
- X Sousa
- Y Ali
- Y Bei
- Y Bekker
- Y Bhahirathan
- Y Bhahirathan
- Y Bharwada
- Y Chechelnitskaya
- Y D Lee
- Y Demiroglu
- Y E Alim
- Y E Aytin
- Y E Karapinar
- Y El Kasmy El Kasmi
- Y El Kasmy El Kasmi
- Y El Kasmy El Kasmi
- Y Embury-Young
- Y Gercek
- Y J Alame
- Y J Lee
- Y J Soh
- Y K Goh
- Y K Lim
- Y Karaman
- Y Kaya
- Y Kaya
- Y L Pang
- Y L Wang
- Y Li
- Y M Tissen
- Y Mahmoudi
- Y Majeed
- Y Mitkov
- Y N Goh
- Y Nikookam
- Y Q Yeo
- Y Qamar
- Y Shafiq
- Y Toyi
- Y Vroom
- Y Xiao
- Y Youssef
- Y Z Beh
- Yiz Acherman
- Z Abdulrahman
- Z Akbar
- Z Al-Saraff
- Z Al-Sarraf
- Z Ali
- Z B Koçak
- Z Ballarini
- Z Carrington
- Z Garoufalia
- Z Goolam-Mahomed
- Z H Sam
- Z Habib
- Z Iqbal
- Z Millar
- Z Ngwenya
- Z Noriega
- Z S Demirci
- Z Sheikh
- Z Xuan Tan
- Z Y Boh
- Z Yi Tew
- Z Yi Tew
- Z Yusuf
- Á Navarro Barrios
- Çagri Girit
- É Dockry
- Ö Kürklü
- Ö Uslu
- Ö Uslu
- Ö Yumurtaci
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2020
- Field of study
Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien-Dindo classification system.Results: A total of 3288 patients were included in the analysis, of whom 301 (9.2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4-7) and 7 (6-8) days respectively (P < 0.001). There were no significant differences in rates of readmission between these groups (6.6 versus 8.0 per cent; P = 0.499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0.90, 95 per cent c.i. 0.55 to 1.46; P = 0.659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34.7 versus 39.5 per cent; major 3.3 versus 3.4 per cent; P = 0.110).Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients
Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery
- Author
- 't Hart E.
- Aabling R. R.
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- Zuzek R.
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2019
- Field of study
Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement
Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study
- Author
- 't Hart E.
- Aabling R. R.
- Aarts C. A. M.
- Aba M.
- Abad-Motos A.
- Abbasguliyev H.
- Abdelgalil R.
- Abdelhameed F.
- Abdulrahman N.
- Abdulrahman S. M. F.
- Abdulrahman Z.
- Abelevich A.
- Abello D.
- Ablett A. D.
- Ablett A. D.
- Abrisqueta J.
- Acherman Y. I. Z.
- Adam A. H.
- Adamo V.
- Adams S. I. B.
- Adel A.
- Adeleye O.
- Adeusi L.
- Adiyaman C.
- Adra M.
- Afsar H. B.
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- Yassaie S.
- Yassaie S. S.
- Yavas M.
- Yavuz G.
- Yeap B.
- Yebes A.
- Yebes A.
- Yelkenci C.
- Yeni M.
- Yeo Y. Q.
- Yeoh T.
- Yesilsancak M.
- Yi Tew Z.
- Yi Tew Z.
- Yildirak M. K.
- Yildirim N.
- Yildirim R.
- Yilmaz B. S.
- Yilmaz D.
- Yilmaz D.
- Yilmaz I.
- Yilmaz M.
- Yilmaz S.
- Yiu J.
- Yong S. Q.
- Yoong A.
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- Young J.
- Youssef H.
- Youssef Y.
- Yu N.
- Yuksek A.
- Yuksek B.
- Yuksek B.
- Yumurtaci O.
- Yurdaor S. S.
- Yurdaor S. S.
- Yusuf Z.
- Zaffaroni G.
- Zaidi A.
- Zalla T.
- Zaman S.
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- Zeb E.
- Zebrak R.
- Zebrak R.
- Zeromskas P.
- Zeynalov F.
- Zhao J.
- Zhao S.
- Zheng S.
- Zhu L. Y.
- Zoikas A.
- Zoikas A.
- Zubowicz M.
- Zuin M.
- Zulkefley N.
- Zuzek R.
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2020
- Field of study
Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56\u20131.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion
Timing of nasogastric tube insertion and the risk of postoperative pneumonia: an international, prospective cohort study
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- Aabling R. R.
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- Šuta Kimle K.
- Žebrák R.
- Žebrák R.
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2020
- Field of study
Aim: Aspiration is a common cause of pneumonia in patients with postoperative ileus. Insertion of a nasogastric tube (NGT) is often performed, but this can be distressing. The aim of this study was to determine whether the timing of NGT insertion after surgery (before versus after vomiting) was associated with reduced rates of pneumonia in patients undergoing elective colorectal surgery. Method: This was a preplanned secondary analysis of a multicentre, prospective cohort study. Patients undergoing elective colorectal surgery between January 2018 and April 2018 were eligible. Those receiving a NGT were divided into three groups, based on the timing of the insertion: routine NGT (inserted at the time of surgery), prophylactic NGT (inserted after surgery but before vomiting) and reactive NGT (inserted after surgery and after vomiting). The primary outcome was the development of pneumonia within 30 days of surgery, which was compared between the prophylactic and reactive NGT groups using multivariable regression analysis. Results: A total of 4715 patients were included in the analysis and 1536 (32.6%) received a NGT. These were classified as routine in 926 (60.3%), reactive in 461 (30.0%) and prophylactic in 149 (9.7%). Two hundred patients (4.2%) developed pneumonia (no NGT 2.7%; routine NGT 5.2%; reactive NGT 10.6%; prophylactic NGT 11.4%). After adjustment for confounding factors, no significant difference in pneumonia rates was detected between the prophylactic and reactive NGT groups (odds ratio 1.03, 95% CI 0.56–1.87, P = 0.932). Conclusion: In patients who required the insertion of a NGT after surgery, prophylactic insertion was not associated with fewer cases of pneumonia within 30 days of surgery compared with reactive insertion
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
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- Abbas Z
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- Hindle Fisher I
- Hirani S
- Hirst F
- Hitchen N
- Ho S
- Ho W
- Hoban Ka
- Hoffman Rpc
- Hogendoorn W
- Holliday Rbs
- Holloway C
- Holmes C
- Holmes Mjv
- Holton P
- Holyoak H
- Home J
- Horgan Pg
- Horne L
- Horst C
- Horth D
- Hoskins Tc
- Hourston Gjm
- Howard James N
- Howells L
- Hu L
- Huang Hc
- Hudson-Phillips S
- Hughes Ba
- Hughes F
- Hughes Rk
- Hulley K
- Hung G
- Hurný M
- Hurst Pc
- Huseynova S
- Husnoo Sb
- Hussain N
- Hussain O
- Hutchings I
- Huzmeli E
- Ibrahim A
- Ibrahim I
- Ilbak A
- Inci Et
- Ingham R
- Ingram E
- Innocenti P
- Iorga R
- Iqbal A
- Iqbal S
- Isaac A
- Isler Vc
- Iyer S
- Jackson Hr
- Jackson S
- Jacob L
- Jafree Dj
- Jaitley A
- Jalota P
- Jamal N
- Janssen Tl
- Jaroš J
- Jathanna N
- Jawad As
- Jayakody N
- Jenkin Sl
- Jenvey C
- Jewell Pd
- Jeyabraba S
- Jhala H
- Jimenez Escovar F
- Jimenez-Gomez Lm
- Jimenez-Segovia M
- Jiménez-Morillas P
- Jiménez-Viñas C
- Jindal A
- Johnston A
- Johnston J
- Johnstone M
- Jones Cs
- Jong N
- Jordan Hem
- Joshi D
- Joshi Kr
- Joyce Hl
- Joyner C
- Jubainville Cl
- Jull P
- Jurgens J
- Kabariti R
- Kadicheeni M
- Kahar A
- Kakil E
- Kalra N
- Kamarajah Sk
- Kanabar S
- Kane T
- Kankam Hkn
- Kara B
- Kara C
- Kara E
- Karabacak U
- Karabulut E
- Karahan B
- Karia M
- Karia P
- Karsan Rb
- Karunakaran P
- Karásek D
- Kasap S
- Kasar P
- Kaushal A
- Kaya A
- Kayacan S
- Kayaci Durak M
- Kazmi Z
- Keane Cp
- Keane N
- Keane P
- Kee Jy
- Keeling Re
- Keelty N
- Keevil H
- Kelesoglu Y
- Kelly M
- Kelly Me
- Kelly N
- Kennedy Ed
- Kennedy Hr
- Kerai A
- Kerimova N
- Kerin Mj
- Kerr Al
- Keyif Mf
- Khaing Ph
- Khajuria A
- Khalid H
- Khan A
- Khan I
- Khan M
- Khan S
- Khan T
- Khan U
- Khangura J
- Khanijau R
- Khatri C
- Khattak M
- Khetarpal Aa
- Khokhar Ha
- Khonat Z
- Khonsari P
- Kiely A
- Kiff R
- Kilic E
- Kilinc C
- Kim Jw
- Kim S
- Kimani L
- King M
- Kip M
- Kishore A
- Kisyov I
- Kitt H
- Kleine E
- Klinkert M
- Kloppenberg Fwh
- Knight Cl
- Kobal Bb
- Koc Ge
- Kocapinar S
- Kocer Md
- Koksal G
- Koksal S
- Kong C
- Kong Cy
- Konsten J
- Kopac O
- Koppe M
- Kosasih Sr
- Koshy Rm
- Kotecha D
- Koumpa F
- Kow K
- Koysombat K
- Koç F
- Koç M
- Kreibich A
- Kretzmer L
- Kucukdiler E
- Kuiper J
- Kuiper Sz
- Kullac S
- Kumar An
- Kumaran G
- Kurklu O
- Kurt A
- Kuzey A
- Kwan Ml
- Kwang P
- Laguna Román S
- Lakhani M
- Lakhani Sm
- Lakshmipathy G
- Lalor P
- Lamont J
- Langenhoff B
- Lankage Cm
- Lap Cr
- Larotonda C
- Laterza V
- Latras-Cortés I
- Laurino A
- Lavery J
- Lazenby D
- Leafe O
- Ledsam A
- Lee Ahy
- Lee J
- Lee S
- Lees Dm
- Lek C
- Leong S
- Leslie Ke
- Leung W
- Leventoglu S
- Lewis T
- Li Hi Shing S
- Li Mm
- Li N
- Licari L
- Liew W
- Liew Y
- Lim Ae
- Lim D
- Lim E
- Lim J
- Lim K
- Lim S
- Lim Sj
- Linton A
- Liu C
- Liu S
- Livesey A
- Lo Secco G
- Lo T
- Lockey Jw
- Logan Ae
- Loke W
- Long F
- Long K
- Longstaff L
- Loo J
- Looijen Rc
- Lopes S
- Lopez Garcia Mc
- Lopez G
- Lotfallah A
- Lou Cn
- Loughran D
- Loveday J
- Low Jyl
- Lowe R
- Lu Q
- Lua Boon Xuan J
- Lucas de Carvalho J
- Luehrman A
- Luhishi A
- Lujan Mompean Ja
- Luk Cy
- Lunawat S
- Lwin Kn
- Lykoudis Pm
- Lynch As
- Lynne S
- Lyons A
- Lyons R
- López-Mármol R
- López-Vendrell L
- Löwensteyn Yn
- Maamari R
- Maan Ds
- Macaskill A
- Macdonald A
- Macdonald J
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- Mackin S
- Maclennan D
- Magnoli M
- Mah J
- Mahboob S
- Mahesh S
- Maheswaran Y
- Mahmood J
- Majid S
- Major C
- Malaj M
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- Malik A
- Mallick S
- Malys Mk
- Manson R
- Mansoor S
- Manvydas V
- Maple N
- Marchal St
- Marchese N
- Marcos Rodrigo A
- Mariani F
- Markham Rm
- Marsden M
- Marsh A
- Marsh L
- Marshall Dc
- Marti Gelonch L
- Martin Morales E
- Martin Al
- Martin R
- Martinez Diaz Jm
- Martinez Rios Ce
- Martorana M
- Martí Fernández Rm
- Martínez Chillarón E
- Maru D
- Mason Jd
- Masood M
- Mastan A
- Mastandrea Bonaviri Gn
- Mate-Mate P
- Matheson J
- Matthams J
- Matthews Bw
- Matthews Jh
- Mauro D
- Maxwell-Armstrong C
- Mayes Jw
- Mazan K
- Mazumdar E
- Mcaleer E
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- Mcallister R
- Mcauley D
- Mcbride A
- Mccabe G
- Mccance E
- Mccann M
- Mcclymont Lf
- Mccormack Dr
- Mccrann C
- Mcdowell M
- Mcenhill Pm
- Mcfarlane H
- Mcgalliard Rj
- Mcgarrigle C
- Mcgarvie S
- Mcgenity C
- Mcgowan C
- Mcgrath A
- Mcgregor Rj
- Mcintyre Cj
- Mckean E
- Mckelvey Ll
- Mckerr Cn
- Mckevitt Kl
- Mclaughin C
- Mclean Rc
- Mclure Sw
- Mcmenamin M
- Mcmullan R
- Mcnamee L
- Mcrobbie Hd
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- Meek J
- Mehdi A
- Mehta Jk
- Meijerink Wjhj
- Menduni N
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- Mensink G
- Mericliler M
- Mermer S
- Messina F
- Mestres Petit N
- Metcalf P
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- Mirallas Viñas O
- Miranda Bh
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- Mirza M
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- Mitha N
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- Mittapalli D
- Mitxelena Elosegi L
- Mizan Sr
- Mogan Yp
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- Moody N
- Moon Rdc
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- Morley R
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- Mortimer A
- Morton D
- Mosterd Cm
- Mugurtay Ys
- Mulder Im
- Muller S
- Mural-Krishnan S
- Muriel P
- Murkin C
- Muro M
- Murphy L
- Murray Se
- Murtaza A
- Murtaza Mi
- Mushtaq J
- Mustafa S
- Musters Gd
- Mutlu B
- Mutlu D
- Myers L
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- Naccari Pm
- Nachiappan R
- Nadanakumaran K
- Naqib S
- Narain A
- Naran P
- Narang Y
- Narayan P
- Narramore R
- Narwani V
- Navayogaarajah V
- Naveed H
- Nayee H
- Neary A
- Nehikhare I
- Nelaj S
- Nelli T
- Neo Yn
- Neophytou C
- Nepogodiev D
- Nesargikar Pn
- Ng Ayl
- Ng Gs
- Ng Jck
- Ng Jq
- Ng K
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- Nicholls K
- Nixon G
- Noone Tm
- Norris Jm
- North As
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- Nota Clma
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- O'Byrne L
- O'Carroll O
- O'Connell C
- O'Connor A
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- O'Dwyer M
- O'Flynn Ld
- O'Kane A
- O'Loughlin Ra
- O'Neill Em
- O'Neill S
- O'Reilly D
- O'Sullivan Da
- O'Sullivan H
- O'Sullivan K
- Oakley T
- Obute Rd
- Odeleye A
- Ogunleye O
- Olivier J
- Omar A
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- Omer Hm
- Onar D
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- Onsal U
- Oostendorp Se
- Oremule B
- Orhalmi J
- Orhan K
- Osei-Kuffour D
- Osman S
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- Oun H
- Owasil R
- Owczarek S
- Ozbalci Gs
- Ozben V
- Ozgencil B
- Ozmen Bb
- Ozsipahi Ac
- Padilla Valverde D
- Paine Hr
- Pal S
- Palanivail N
- Palkhi E
- Pallara E
- Palmer C
- Palmieri A
- Palmisano S
- Palos Campos Mc
- Palyzová H
- Pandey A
- Pandey G
- Pando Ruiz B
- Pang G
- Pantalone Mr
- Paolo G
- Papandrea M
- Papazachariou Sk
- Parajo A
- Paraoan V
- Parimli H
- Parinisi Z
- Park Jh
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- Parkin J
- Parmar E
- Parsons S
- Parthiban S
- Pasquali S
- Pasqualoni M
- Pastor-Riquelme P
- Pata F
- Patel B
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- Patel By
- Patel Jb
- Patel K
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- Patel N
- Patel P
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- Patel T
- Patel V
- Pattapola V
- Patturelli M
- Paul J
- Pearce J
- Pearse Rj
- Peck Fs
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- Peinado Iribar B
- Pektas Am
- Pellino G
- Perera M
- Perez Arias H
- Perez Costoya C
- Perez Febles M
- Perez Jl
- Perez-Gandara B
- Pericleous A
- Peroos S
- Perrotta G
- Persiani R
- Pesser N
- Peters M
- Petra H
- Petrarca M
- Petrov G
- Pezas Tp
- Pezzuto R
- Phan Pn
- Phillips C
- Picciariello A
- Pickard J
- Pietrabissa A
- Pike G
- Pineño-Flores C
- Pinkney Td
- Pinto R
- Piquet A
- Piraliyev E
- Piran G
- Pistola I
- Pitts-Tucker T
- Pizzolato A
- Pla Seró S
- Player C
- Plomer-Sanchez M
- Poacher A
- Poelman M
- Polat F
- Polat Zp
- Ponweera A
- Poo Sx
- Pope S
- Portugal Porras V
- Posada M
- Posteki G
- Poyato Nuñez Fj
- Prabhudesai A
- Prado Perez R
- Prakash E
- Preece R
- Prest-Smith J
- Priani P
- Priestland R
- Prieto-Nieto Mi
- Pronk A
- Protti Ruiz Gp
- Prys-Jones O
- Ptacek Ib
- Puan L
- Puccioni C
- Pujol-Cano N
- Pulpito S
- Punj R
- Punjabi N
- Pös M
- Qamar Ma
- Quill S
- Quinn K
- Qureshi A
- Qureshi S
- Qureshi U
- Rabinthiran S
- Radotra A
- Rafiq Nm
- Raghuvir V
- Raghvani T
- Rahmee Cns
- Raimondi P
- Raina V
- Rajan N
- Raji K
- Rakhimov I
- Raman Kp
- Ramana A
- Ramjeeawon N
- Ramnarine A
- Rampal R
- Rampulla V
- Ramsay N
- Ramtoola T
- Randisi B
- Rangan T
- Rangedara A
- Raphael M
- Rashid M
- Rashid S
- Rasiah Mg
- Ratnakumaran R
- Rattan G
- Ratu Sg
- Raurich-Leandro J
- Raut P
- Reakes T
- Realis Luc A
- Redgrave Na
- Redmond A
- Reed A
- Reeder C
- Reehal Rs
- Rees C
- Rees S
- Reeves T
- Reggiani L
- Reid Kg
- Reid Nb
- Reid R
- Rejayee M
- Remedios J
- Remore Lm
- Reynolds J
- Rhema Ia
- Ribbink Me
- Ridgway P
- Rinkoff S
- Ripa M
- Riva L
- Riva M
- Rizzi A
- Rob T
- Roberts Aw
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- Roberts Ej
- Roberts Hf
- Robertson Dt
- Robertson Kl
- Robertson V
- Robinson C
- Robinson M
- Robson J
- Rocco I
- Roche D
- Rocke As
- Rodrigues Silva K
- Rodriguez Garcia R
- Rogers Je
- Rogers S
- Rojoa D
- Romano F
- Romeo F
- Romero-Simó M
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- Roquet Puigneró E
- Rosati G
- Rosati R
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- Rossi E
- Rothwell L
- Roura J
- Roy Csd
- Rubbini M
- Rubio-Perez I
- Ruiz Montesinos I
- Ruiz Em
- Russell G
- Ryan M
- Saat Mi
- Sabine Lm
- Sacco R
- Sagar R
- Saglam Za
- Sagmeister M
- Sahathevan A
- Sahin A
- Sait Ms
- Sajjad U
- Sakman G
- Salam Gj
- Salamone G
- Salazar-García C
- Sale T
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- Salih Ae
- Salman M
- Salmon D
- Sam Zh
- Sammarco G
- Sampietro G
- San Martín Bragado M
- Sanchez Cambronero M
- Sanchez A
- Sanchez-Guillen L
- Sanders Ja
- Sandhu Kk
- Sandhu S
- Sandison L
- Sangal P
- Santocchi P
- Sanz Ortega G
- Sapci I
- Saraceno F
- Sari V
- Sartori A
- Sarvanandan T
- Sarwar S
- Sasapu K
- Satterthwaite L
- Schasfoort Ra
- Schiphorst A
- Schizas A
- Schmidt Pa
- Schofield E
- Schok T
- Schulz Tm
- Schulzová M
- Scotcher Se
- Seager E
- Sebaoui S
- Secilmis E
- Sedee Wja
- Seedat M
- Segall E
- Segura-Sampedro Jj
- Sellathurai J
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- Semiz A
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- Semple E
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- Senay Bb
- Seneviratne N
- Sengul N
- Sensi B
- Senturk E
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- Sette M
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- Seyrek N
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- Sgrò A
- Shafi Ama
- Shafiq Nm
- Shah A
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- Shah R
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- Shahidi S
- Shakweh E
- Shamsul Badrin Ak
- Shanahan D
- Sharifpour M
- Sharma Khatiwada A
- Shatkar V
- Shaunak R
- Sheikh Imi
- Sheldon A
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- Sheth S
- Shoa M
- Shufflebotham H
- Shuker Ba
- Shukla A
- Shumon S
- Shurovi B
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- Shuttleworth Rh
- Sica G
- Siddiqui M
- Siddiqui Zh
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- Simpson A
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- Singh B
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- Sinha A
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- Sirakaya M
- Sitta O
- Sivrikaya T
- Skalamera I
- Slade R
- Slieker Fjb
- Smart Nj
- Smeets Hj
- Smet M
- Smith Acd
- Smith Ag
- Smith Dne
- Smith N
- Smolák P
- Sng S
- Soldevila-Verdeguer C
- Soo Yh
- Soon Wc
- Sorah T
- Soria Aledo V
- Sotona O
- Soylemez Zobb
- Sozuer Em
- Spence O
- Spencer T
- Spijkerman R
- Springford Lr
- Sproule L
- Sreh A
- Srikantharajah M
- Sritharan P
- Staderini F
- Stanger Sa
- Stanley Gh
- Stanley S
- Stassen Lps
- Stather Pw
- Steccanella F
- Stechman M
- Steel M
- Stein J
- Stellingwerf Me
- Steup Wh
- Stevens S
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- Stezaker S
- Stijns Rch
- Stoddart Mt
- Stokes S
- Stone Ej
- Stott Gd
- Strange E
- Street An
- Subasi A
- Sukkari M
- Sukumar S
- Suleman Yn
- Sullivan Jal
- Sun E
- Sundar-Singh M
- Suppa A
- Suresh Rs
- Suresh S
- Syeed Ja
- Sykes Mc
- Szczap A
- Sánchez Estébanez E
- Sánchez-Blasco L
- Tagariello F
- Tahir M
- Tahmina A
- Tai A
- Talukdar Ss
- Tan D
- Tan Esm
- Tan Et
- Tan R
- Tan S
- Tan Y
- Tan Yh
- Tansoker I
- Tarantino M
- Targa S
- Taskin O
- Taskin Rb
- Tavuz Ai
- Tay Ay
- Tayeh S
- Taylor F
- Taşçı Y
- Tear Ak
- Teh Jw
- Teixeira da Silva M
- Tejero Pintor Fj
- Telfer R
- Temiz C
- Teng V
- Teoh Pj
- Ter Bruggen Ffja
- Ter Horst L
- Ter Weele K
- Thacoor A
- Thakker Ce
- Thakur H
- Tharakan Rg
- Tharmachandirar T
- Theodoreson Md
- Theodoropoulou K
- Thethi R
- Thevathasan Aa
- Thirumal V
- Thomas D
- Thomas G
- Thomas-Davies M
- Thompson Jd
- Thompson Od
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- Tilston Tw
- Tippins F
- Tirnaksiz Mb
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- Tognolo L
- Toh C
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- Tonkins M
- Toorenvliet Br
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- Topham C
- Torlot Ge
- Torrance Hd
- Tosun V
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- Trail M
- Traynor Bp
- Trecarten S
- Trimble A
- Trist Aj
- Troia A
- Trompetto M
- Truma A
- Truss A
- Tsui Ay
- Tulum H
- Tung L
- Turaga S
- Turati L
- Turkmen M
- Turley H
- Turnbull Ja
- Turner Ejh
- Turner J
- Turner L
- Turner M
- Turpan M
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- Ucar E
- Uctepe F
- Uittenbogaart M
- Ulkucu A
- Ulusahin M
- Unal Ag
- Ungcharoen N
- Uppal E
- Urquhart A
- Uzun B
- Uzun O
- Uzun S
- Uzunoglu Ec
- Vable T
- Valderrama Pérez A
- Valli A
- Vallve-Bernal M
- Van Bruggen D
- van Dalen Ashm
- van de Ven Awh
- van der Harst E
- van der Hoeven Ac
- Van der Lubbe M
- van der Pool Aem
- van der Zee C
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- van Elst Tr
- van Engelenburg T
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- Van Grevenstein Wmu
- Van Heumen Tm
- van Leeuwen Bl
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- van Steensel L
- Van Tol Rr
- van Verschuer Vmt
- van Wijnbergen Jwm
- Vanmali P
- Varley R
- Varma D
- Varma N
- Varma Rk
- Varo Muñoz A
- Vasko P
- Vasquez G
- Vaughan R
- Vazquez-Gonzalez I
- Veenker Cgh
- Vela Polanco Ff
- Vendramin E
- Venn M
- Ventre Cm
- Venturini S
- Verardi L
- Verboeket B
- Verma K
- Verma S
- Vermaas M
- Vernon Ok
- Villarejo Campos P
- Vinci A
- Vithanage Na
- Vivekanantham S
- Vives-Rodriguez E
- Viñas-Salas J
- Vries Jjm
- Wadanamby S
- Waldron Rm
- Walford Ra
- Wali A
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- Walsh Sl
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- Wang A
- Wang S
- Ward Ae
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- Warren N
- Warwick Hl
- Watson N
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- Webb E
- Weinberg D
- Wells M
- Weston C
- Wetherall N
- Whacha C
- Whatling Ea
- Whewell H
- White A
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- White U
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- Whitham Rdj
- Whittingham H
- Wiersema R
- Wiezer R
- Wijesekera M
- Wijffels N
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- Willems L
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- Wills J
- Wilson H
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- Wiltshire Jj
- Winarski A
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- Winslow F
- Woin E
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- Wood Ad
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- Woodward H
- Woon E
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- Wright Ev
- Wye J
- Wylam D
- Wylie J
- Wynell-Mayow Wm
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- Xu Gx
- Xylas D
- Yalcin Y
- Yaman S
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- Yates Ja
- Yauw S
- Yavuz G
- Yazkan Z
- Yekenkurul E
- Yener A
- Yeoh Tsl
- Yetiskin E
- Yıgman S
- Yildirim N
- Yildirim R
- Yildiz S
- Yildiz Ss
- Yildiz T
- Yilmaz I
- Yilmaz M
- Yilmaz S
- Yilmaz T
- Yim N
- Yoganathan S
- Yong Cs
- Yong N
- Yoruk I
- Yousif A
- Yow L
- Yuen R
- Yuksek B
- Yuksek Ma
- Yuksel A
- Yurdaor Ss
- Yurekli Am
- Zaidi R
- Zegeye Mi
- Zengin T
- Zhang Aa
- Zhao J
- Ziff O
- Zigiotto D
- Zijlmans Jl
- Zimmerman D
- Ziprin P
- Zope S
- Zuhair M
- Örhalmi J
- Özkan Bb
- Šimáčková B
- Široká M
- Žebrák R
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien\u2013Dindo Grades III\u2013V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49\u20132.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46\u20130.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease