64 research outputs found
Evaluation of use effective microorganisms (EM) with different feeding strategies on growth performance, body chemical composition and economic efficiency of monosex Nile tilapia Oreochromis niloticus juveniles
- Publication venue
- 'EDP Sciences'
- Publication date
- 01/01/2021
- Field of study
A factorial trial was conducted to detect the effect of different feeding strategies of supplementation of effective microorganisms (EM) liquid on the growth performance, feed utilization, body chemical composition and economic efficiency of monosex Nile tilapia (Oreochromis niloticus) juveniles. Three experimental treatments were formulated a basal diet without any addition of EM (control; A), a diet supplemented with 2% EM (B), and a diet supplemented with 4% EM (C). All treatments were offered to fish through two different strategies of feeding the meal: 2/3 in the morning and 1/3 in the afternoon or 1/3 in the morning and 2/3 in the afternoon. Each treatment was replicated three times. Juveniles Nile tilapia with an average initial body weight of 3.85 ± 0.22 g (± SE) were randomly stocked at a rate of 90 juveniles per 1.5 m3 tank. Fish growth performance and feed utilization significantly (P ≤ 0.05) increased with increasing EM supplementation and were positively affected by different feeding strategies. Moreover, the economic evaluation showed that there were more benefits by when using the 4% EM diet and feeding 2/3 of daily meal in the morning
Influence of reaction time and synthesis temperature on the physical properties of ZnO nanoparticles synthesized by the hydrothermal method
- Author
- A Benazir
- A Jagannatha Reddy
- AK Barve
- AMO Dalia
- AR Reddy
- AS Nehal
- B Sunandan
- C Aydın
- CH Ahn
- CM Jay
- DM Fernandes
- ER Shaaban
- F Ahmed
- H Ma
- H. S. Wasly
- HP Suryawanshi
- J Markmann
- JL Watson
- JN Hasnidawani
- JW Rasmussen
- K Venkateswarlu
- K Zheng
- KG Williamson
- KP Kamal
- M Vaseem
- M. S. Abd El-Sadek
- Mohamed Henini
- NA Salahuddin
- R Bekkari
- RA Zargar
- S Bagheri
- S Fujita
- S Klubnuan
- S Sabita
- SD Lee
- SKV Sesha
- SN Shaha
- Y Hu
- Y Xie
- Z An-Qi
- ZW Liang
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 02/01/2018
- Field of study
Influence of synthesis temperature and reaction time on the structural and optical properties of ZnO nanoparticles synthesized by the hydrothermal method was investigated using X-ray diffraction (XRD), high resolution transmission electron microscopy (HR-TEM), energy-dispersive X-ray, Fourier transform infra-red spectroscopy, and UV–visible and fluorescence spectroscopy. The XRD pattern and HR-TEM images confirmed the presence of crystalline hexagonal wurtzite ZnO nanoparticles with average crystallite size in the range 30–40 nm. Their energy gap determined by fluorescence was found to depend on the synthesis temperature and reaction time with values in the range 2.90–3.78 eV. Thermal analysis, thermogravimetric and the differential scanning calorimetry were used to study the thermal reactions and weight loss with heat of the prepared ZnO nanoparticles
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
- Author
- Aamir Faiqa Binte
- Aamir Syed Roohan
- Ababneh Adnan
- Abbal Muhammad Anas
- Abbas Ahmed M
- Abbas Mostafa
- Abd-Albain Montasir A
- Abdalei Abdulwahab
- Abdalla Ahmed
- Abdalla Ahmed Yassir
- Abdalla Mohamed Galal Ali
- Abdalla Zainab
- Abdallah Mohamed M
- Abdalmahmoud Noon Ezzeldien
- Abdalsadeg Rowa
- Abdelaal Ahmed M
- Abdelbagi Alnazeer Y
- Abdelbaky Mostafa
- Abdelbaset Doaa
- AbdElbaset Esraa
- Abdelbast Menhag
- Abdelfatah Mohammed Abdelnasser
- Abdelgawad Samia
- Abdelhamid Mohamed M
- Abdeljaber Mahmoud
- Abdelkhalig Mubarak
- Abdelmaksoud Mohamed
- Abdelmeguid Rana
- Abdelmelek Dhia Errahmane
- Abdelnaeam Samah
- Abdelnasser Mohammad K
- Abdelrahim Najwa
- Abdelrahman Amira
- Abdelrahman Ayman
- Abdelsalam Hebatalla
- Abdelsamed Enas Abdelbaset
- Abdelwahab Khaled
- Abdoun Meriem
- Abdulali Fatima
- Abdulaziz Mohamed
- Abdulla Dheba Almukhtar
- Abdullah Bahiyah
- Abdullah Bahiyah
- Abdullah Walaa
- Abdullahi Habiba Ibrahim
- Abdulrahman Ahmed
- Abdulrasheed Lubabatu
- Abdulwahed Eman
- Abdulwahed Eman
- Abeysirigunawardana Dewmi
- Abidin Muhammad Fihmi Zainal
- Abiola Olukayode
- Abiyere Henry
- Abodina Ahmed Mohammed
- Aboelela Reham
- AboElfarh Hadeer Elsaeed
- Aboudlal Husein
- AbouHiekal Osama
- Aboulfotouh Ahmed
- Abozid Anwaar
- Abubaker Noora
- Abubaker Noora
- Abufanas Asma
- Abughanima Mahmoud
- Abuhashem Shehab
- Abulafia Daniel
- Abushaala Fatima
- Abushanab Khaled
- AbuShawareb Issa
- Abuuqteish Hamza
- Abuzaho Amany
- Achem Arome
- Adam Eithar
- Adam Mohammed
- Adam Mohammed A
- Addalla Mohamed
- Addley Jordan
- Adeleye Gbadebo
- Adeniyi Adebayo
- Adewole Nathaniel
- Adeyemo Olabisi
- Adeyeye Ademola
- Adeyeye Ademola
- Adly Michael
- Adnan Siti Nasyirah Nisya
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adze Joel Amwe
- Afeikhena Ehis
- Agida Teddy
- Agilla Hamza
- Agnew Emilie
- Agu Joy Onyekachi
- Ahmad Zatul Akmar
- Ahmed Abdalla
- Ahmed Ahmed
- Ahmed Ahmed
- Ahmed Alaaaldeen
- Ahmed Entisar
- Ahmed Habeeba
- Ahmed Hatem
- Ahmed Reem
- Ahmed Rehab
- Ahmed Rihab
- Ahmed Rogia Ahmed Abdalla
- Ahmed Ruaa
- Ahmed Sharwany
- Ahmed Uzair
- Ahmed Wahiba
- Ahmeed Sultan
- Airede Lydia Regina
- Aitchison Lori
- Ajredini Mirac
- Ajulo Adeshina A
- Akaba Godwin
- Akasha Mazin
- Akbar Maha Ghulam
- Akbuz Seyma Orcan
- Akdere Hakan
- Akın Bilge
- Akkaya Ege Nur
- Akpamgbo Chukwunonso Nnamdi
- Akwaisah Ayoub
- Al Hammoud Amr
- Al Rawashdeh Toka
- Al-Baw Mahmoud
- Al-Dahdouh Mosheer
- Al-Haek Safa’
- Al-Hazaimeh Mo'ath
- Al-issawi Dima
- Al-Issawi Subhi
- Al-jammal Maryam
- Al-Juaifari Maytham A
- Al-Mwajeh Tesneem
- Al-Omary Sohaib
- Al-Quossi Mohammed
- Al-Shambaty Yasir Babkir Ali
- Al-Shami Qotadah
- Al-Smirat Heba
- Al-Tahayneh Sief-Addeen
- Al-Touny Aiman
- Al-Touny Shimaa
- Al-zawaydeh Alia
- Alaa Ali
- Alabed Ebtihal
- Alagelli Fatma
- Alagoz Ahmet Can
- Alameen Hind
- Alameen Maram
- Alamlih Laith
- Alaqoubi Retaj
- Alarabi Rehab
- Alariby Fatima
- Alatefi Dawood
- Alathameen Nassar
- Albakosh Bashir Abobaker
- Albanopoulos Konstantinos
- Albarhomy Osama
- Albarki Aisha
- Albashaireh Alaa
- Albatni Safa Sasi
- Albayadi Eslam
- Alboon Mosab
- Alboridy Muneera
- Alboueishi Asraa Ali
- Aldeges Marwan
- Aldreawi Mohammed
- Alflite Asil Omar Saleh
- Alfrijat Tamam
- Alfrjani Tariq
- Algabbasi Salima
- Algatanesh Nassib
- Alhadad Qamrah
- Alhaddad Hoda Salem
- Alhaleem Ayah
- Alhaleeq Saif
- Alharam Abtisam
- Alhashimi Abdulhadi Mohammed Alhadi
- Alhassan Monzer
- Alhudhairy Sara
- Ali Ahmed
- Ali Aml
- Ali Doua
- Ali Eithar M
- Ali Iqra Fatima Munawar
- Ali Maab
- Ali Manal
- Ali Muhammad
- Ali Radwa
- Ali Rawan Alsheikh
- Ali Rzan Ali Hamedelneel
- Ali Shehroz
- Aliosin Oleg
- Aljamal Mohammad
- Aljamal Sarah
- Alkaraja Layth
- Alkaseek Akram
- Alkazali Mustafa
- Alkchr Hayat Ben Hasan Mohamed A A
- Alkhatib Abed Alazeez
- Allam Shereen
- Almahroush Marin
- Almakki Doha Mohammed Ahmed
- Alnajjar Lara
- Alnajjar Majjd
- Alnatsheh Wesam
- Alnour Ammar
- Alomar Rabiaa
- Alomari Yazan
- Alqaarh Aya
- Alragig Zahra
- Alrifae Ghaliya Mohamed H
- Alrosan Risan
- Alsagoff Sharifah Nor Amirah Syed Abdul Latiff
- Alsaid Hamza
- Alsaify Esmat
- Alsaih Sawsan
- Alsari Najah
- Alshareea Entisar
- Alshawadfy Abdelrhman
- Alshawesh Aisha
- Alsheik Ahmad
- Alsori Mohamed
- Alsoudani Ali
- Altabbaa Hashem
- Altahir Mohamed
- Altair Mawadda
- Altaweel Ahmad
- Altughar Bushra
- Alvarez Matias
- Alvarez-Lozada Luis Adrian
- Alvarez-Lozada Luis Adrian
- Alwahaib Anas
- Alwash Mohammed
- Alzarga Ali
- Alzarouq Ebtisam
- Alzarroug Amal
- Alzghoul Bader
- Alzyoud Osama
- Amarasekara Mishka
- Amary Marwa
- Ametov Amet
- Amin Mostafa K
- Aminu Bashiru
- Aminu Muhammad Baffah
- Ammar Ahmed Siddique
- Amro Dana
- Ananthapadmanabhan Shravankrishna
- Anderson Paul
- Andrew Paul Chimezie
- Andriani Adelaide
- Anestiadou Elissavet
- Angelis Fragkiskos
- Angeslis Fragkiskos
- Aqeel Syed Talha Bin
- Aral Canan
- Arebi Jaber
- Arnaoutoglou Eleni
- Arslangilay Mert
- Arvanitaki Alexandra
- Asadyari-Lupo Shadie
- Ashar Nur Ayuni Khirul
- Ashour Amira
- Ashraf Hamza
- Ashur Abir Ben
- Asjad Imran
- Askar Aamal
- Askin Abdullah Emre
- Aslam Muhammad Nadeem
- Aslan Merve
- Aslangilay Mert
- Astal Mohammed
- Asudo Felicia
- Atadag Yildiz Buyukdereli
- Atef Dina
- Athamneh Tayseer
- Athanasiadis Apostolos
- Ather M Hammad
- Atherton Kristy
- Atia Ahmed
- Atici Semra Demirli
- Atilhan Ridvan
- Atim Terkaa
- Atiq Tabish
- Atta Raneem
- Attia Mohamed
- Attiya Omar
- Awad Hasan
- Awadallah Safaa
- Awoyinka Babatunde
- Ayasrah Salem
- Aydin Cemil
- Aydoğdu Erhan Onur
- Ayogu Emeka
- Ayoub Kerillos
- Ayyad Alaa
- Azboy Ibrahim
- Azer Armia
- Azhari Malaz
- Aziz Aliya Begum
- Babalola Olakunle
- Babar Daniyal
- Babekir Enas Mohammedtom Abdulhameed
- Babiker Afra
- Bacariza Loreto
- Baccar Marwen
- Badawy Asmaa
- Badi Hussameddin
- Badr Karim
- Badri Danniel
- Bagazi Doaa
- Bailey Ashley
- Bakare Adewumi
- Bakari Maisaratu A
- Bakeer Hibah Bileid
- Bakeer Mohammed
- Balciscueta Zutoia
- Ballah Shirahn
- Balogh Zsolt
- Baltacı Zeynep Hazal
- Banaga Essam Eldien Abuobaida
- Banerjee Arnab
- Banihani Farah
- Barbara Silvia Jasmine
- Barbaro Antonio
- Bareka Metaxia
- Bariun Yara
- Barka Sharf
- Barker John
- Barker Sally
- Barsoum Fady
- Basam Aya
- Basam Aya
- Bassam Ahmad
- Bassey Asi-oqua
- Bataineh Saad
- Bature Stephen Bodam
- Bayram Cigdem
- Baysallar Duygu
- Baziotis-Kalfas Kristian
- Beatson Nicholas
- Bei Michael
- Bektas Sebnem
- Bell David
- Benamor Oumayma
- Benek Duygu Ece
- Benham Emily
- Benismai Israa
- Bensalem Marya
- Bensalem Serien Hossain
- Benyani Simran Vinod
- Bernabei Massimiliano
- Betts Aisling
- Bezweek Adel
- Bhikha Jainey
- Bindra Randipsingh
- Binnawara Muhannud
- Bird Katie
- Bisgin Tayfun
- Bitsianis Stefanos
- Blake Jessica
- Bland Laura
- Blassey Aneel
- Blundell Jian
- Bobba Sriya
- Bockxmeer John Van
- Bolam Scott Matthew
- Bolton Damien
- Bosi Simone
- Bouaoud Souad
- Bouchenak Kamel
- Boussahel Ikram Fatima Zohra
- Bowman Sarah
- Boyd Theresa
- Boyes Hamish
- Boyley Jessica
- Bozhko Maxim
- Bozkir Haktan Ovul
- Bozkurt Mehmet Abdussamet
- Bresadola Vittorio
- Brewster Dani
- Brooke Kenya
- Brown Georgia
- Brown Matthew
- Buari Taiwo
- Buhavac Milos
- Bunjo Zachary
- Burrows Emalee
- Burruso Luca
- Busaidi Ibrahim S Al
- Bushaala Hassan
- Butterworth Yasmine
- Butyrskii Aleksandr
- Cabalag Carlos
- Cade Richard
- Cakcak Ibrahim Ethem
- Cakir Niyazi
- Calini Giacomo
- Calini Giacomo
- Camkıran Elifsu
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- Candan Mert
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- Canton Joshua
- Capar Mehmet Ali
- Cardelli Stefano
- Carlos Angela
- Carnuccio Emma
- Carre Xenia
- Casciola Francesca
- Castagnini Francesco
- Catalioto Caterina
- Cepe Hale
- Cerinic Pietro Matucci
- Certel Alperen Taha
- Cetınkaya Zeynep Sahan
- Chakroun Sawssen
- Chambers Jessica
- Champipis Apostolos
- Chan Alex
- Chan Ashley
- Chan Juliet
- Chan Justin
- Chan Nicholas
- Chand Namisha
- Chandiok Karan
- Chandler Callum
- Chandra Pooja
- Chang Jared
- Chang Kelvin
- Changati Varun
- Chao Phoebe
- Chau Michelle
- Chau Michelle
- Chauhan Karanjeet
- Chawla Tabish
- Chen Andrew
- Chen Brian
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- Chen Yan
- Chene Danielle
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- Chidambaram Seevakan
- Chilaka Lalitya
- Chlebicka Tara
- Choi Colin Chan-Min
- Choi Horim
- Choong Zhi Shyuan
- Chou Justin
- Chowdhury Nebula
- Chowdhury Sharfuddin
- Chua Alan
- Chua Alyssa
- Chua Anne Qi
- Chua Matthew
- Chye David
- Cianci Pasquale
- Ciranni Dominico
- Clair Sophie St
- Clanfield Matthew
- Clarnette Nick
- Clemente-Navarro Pablo
- Cobden Andrew
- Colaco Ashley
- Collins A-J
- Collins Josh
- Conlon Niamh
- Conversano Ivana
- Cook Holly
- Coomber Grace
- Copertino Nicolas
- Cordingley Timothy
- Cornwell Charlotte
- Cornwell Charlotte
- Corrigan Angela
- Cover Jacinta
- Craig-Lucas Alayna
- Crossman Mason
- Crostella
- Crotty Anna
- Cuneo Beatriz
- Currie William
- Cuthbert Mitchell
- Cyr Kathryn
- Çolak Eli ̇f
- Dabas Ayman Arhuma
- Dagklis Themistoklis
- Dagsali Alara Ece
- Dahshan Shaimaa
- Dajti Gerti
- Dang Jennifer
- Das Ankita
- Das Ankita
- Daud Mohamed Ashraf Mohamed
- Daudu Davina
- Davies Lily
- Dawod Nimatee
- Dawood Ali
- Dawson Abby
- Dawson Amanda
- Dawson Amanda
- Deafallah Asmaa
- Demirkiran Mehmet Ali
- Denby Hannah
- Dennaoui Rami
- Derwish Khawla
- Dharmaratne Isini
- Diab Menna
- Dimofte Mihail Gabriel
- Dindar Arzu
- Ding George
- Divekar Tanya
- Divinagracia Janelle
- Dogan Tugce
- Domenech Julio
- Donaldson Olivia
- Dong Isabella
- Dong Jason
- Donia Mohamed
- Dorovinis Panagiotis
- Douglas Rebecca Indiana
- Doulami Georgia
- Dowdle Benjamin
- Duart Mireia
- Dudi-Venkata Nagendra
- Duffield Jaime
- Durdu Beyza
- Durmus Elif
- Düzyol Zeynep
- Dzator Stephen
- Ebrahim Alshymaa
- Edwards Elton
- Edwards Liam
- Edwards Liam
- Egerton James
- Egzait Raneem
- Eid Ahmed
- Eismontas Vitalijus
- Ejaz Adya
- Ejembi Peter
- Ekwebelam Jennifer
- El-Masry Mariam
- el-mola Amira Gad
- El-Sakka Ahmed
- El-Taher Ahmed Kamal
- Elaagib Amna
- Eldaim Khalid Nour
- Eldarat Tarik Ahmed
- Eldomiaty Donia
- Elessi Khamis
- Elewa Ahmed
- Elfadli Mustafa
- Elfallah Sara
- Elfeki Hossam
- Elferis Donia
- Elgadi Tahani
- Elghamry Ahmed
- Elgharib Asmaa Moatasem
- Elghazy Mohamed Abdelaziz
- Elgherwi Laila
- Elghoul Youssef
- Elgindy Yara
- Elhadi Muhammed
- Elhadi Muhammed
- Elhadi Muhammed
- Elhadi Rawan Elnoman Hamadelniel
- Elhassan Baraa
- Elia Michael
- Elieyioğlu Güşta
- Elizabeth
- Elkenawi Karim
- Elkharaz Omar A
- Elkheshebi Ahlam
- Elkhodary Ahmed
- Ellepola Hasthika
- Ellilly Ahmed
- Elmaghrabey Abdallah
- Elmehdawi Haitham
- Elmubark Abdelhadi
- Elnagar Rahma
- Elporgay Aya
- Elreaid Fadwa
- Elreaid Fatma Fathi
- Elrishi Fatheia
- Elsaied Mostafa
- Elsawy Amr
- Eltaib Ibrahim
- Eltayeb Mohammed Omer Mohammed
- Elyan Basel
- Elzoubia Joma
- Emad Humam
- Emam Asmaa
- Emhimmed David
- Enaami Husam
- English Tessa
- Eniola Bolarinwa
- Erginoz Ergin
- Esaiti Salma
- Esho Adriana
- Evans Natalie
- Ezeoke Grace
- Fabbri Nicolò
- fadalah Bader Abo
- Fadlalmola Hammad
- Faisal Arwa
- Fang Carol
- Farag Abdelrahman
- Fares Gamal Elsayed
- Faris Farah
- Fariyike Bunmi
- Farre Joan
- Farrell Michael
- Farrell Michael
- Fasiku Olushola
- Fatima Aleeza
- Fearnley-Fitzgerald Chekodi
- Febre Jorge
- Feierdaiweisi Xireaili
- Feo Carlo V
- Fergar Cem
- Ferguson Liam
- Ferguson Neil
- Fernando Isuru
- Figgitt Ethan
- Filikus Abraham L
- Flame Aki
- Fletcher Joseph
- Flintoft Sean
- Flores-González Ana Karina
- Fong Bryan
- Fong Hakim
- Fong Pei Jun
- Foo Jonathon
- Forbes Clara
- Forsythe Jack
- Fotheringham Penelope
- Fouda Mohamed Fayez
- Fradelos Evangelos
- Franks Angus
- Fraser Calvin
- Frost Taylor
- Fu Jeff
- Fu Yangzirui
- Fuentes Stephie Oyervides
- Fufore Mohammed Bello
- Fujihara Asuka
- Fung James
- Furey Joseph
- Gaafar Mohammed
- Gaarour Osama Samir
- Gaborit Lorane
- Gaborit Lorane
- Gahwagi Milad
- Galal Adham
- Galal-Eldin Sami
- Gallert Kayla
- Gamage Tharushi
- Gan Christine
- Gan Kathy
- Gan Siang Wei
- Gara Mouna
- Garba Mohammad Albuhari
- Garcia Sara
- García Patricia Ludivina González
- Garton Briar
- Garza Alejandro Quiroga
- Garza Francisco Javier Arrambide
- Gattesco Davide
- Gattulli Domenico
- Gebeh Alpha
- Gecici Mehmet Emre
- Gemici Aylin
- Geng Ruxi
- Gentle Juliette
- George Akhita
- George Ria
- Gera Sahil
- Gernhoefer Erin
- Ghaly Moheb
- Ghandi Kushan
- Ghanem Sohila
- Ghemmied Malak
- Ghmagh Rawia
- Ghmagh Reem
- Giannakopoulos Konstantinos S
- Gidiem Doaa
- Gill Sonia
- Gilmore Paul
- Gineeb Hana Yousef
- Giurgius Mary
- Giuzzardi Giulia
- Glyn Tamara
- Glynatsis John
- Glynatsis John
- Goddard Kim
- Goh Sarah
- Goh Sarah
- Goh Sarah
- Gojnich Amy
- Golani Shalni
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- Goldsmith Oliver
- Golja Damian
- Goonawardena Janindu
- Gopal Hemashree
- Gorgone Mara
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- Gover Tolga
- Grada Maren
- Grandi Alyssia De
- Graziadei Vivien
- Green Jemma
- Greenwood Emily
- Greig Hannah
- Grillea Giorgia
- Groot Julia De
- Gross Hannah
- Guerra Ethel Valeria Orta
- Guerra-Juárez Yesika Alejandra
- Guizzardi Giulia
- Gunasekara Aashrinee De Silva Abeweera
- Gundara Justin
- Guner Ali
- Gunn Emma
- Guo Oscar
- Gündoğdu Adnan
- Gweder Rima
- Gyftopoulos Argyrios
- Hadi Arwa
- Hadi Arwa
- Haege Emma
- Haggag Zeyad
- Hakak Fatima
- Halawa Mohamed
- Hamad Huda
- Hamdy Ahmed
- Hamdy Omar
- Hamer Peter
- Hamid Hytham K S
- Hammouri Ibraheem
- Hamoda Esraa
- hamoud Mohammad Al
- Hamza Alla Aldeen
- Hana Kerolous
- Hanan Aishath
- Hantes Michael
- Harb Fatma
- Hardidge Andrew
- Hares Mohamed M
- Hariharan Shubhang
- Harmston Christopher
- Haroon Ola
- Harris Alasdair
- Harrison Ella
- Hasan Najat Ben
- Hashem Ahmed Mohamed
- Hashem Boshra
- Hassan Majd
- Hassan Mohamed
- Hassan Muaz
- Hassan Shimaa Abbas
- Hassan Suhaib
- Hassan Tawfieg
- Hassan Yusuf
- Hassanein Mahmoud
- Hau Yin Chi Hebe
- Hauptman Samantha
- Hauptman Samantha
- Haximolla Hodo
- Hazaymeh Omar
- Healy Tom
- Heaney Emily
- Heard Matthew
- Hegazy Dana
- Heigan Rachael
- Hemaida Tarek
- Hendawy Hamdy
- Henes Kerollos
- Hernandez Gilmer Omar Perez
- Hewton Lewis
- Hezam Abdulhakim
- Hilail Ihab Abu
- Hilal Nadir
- Hilder Amie
- Hilder Amie
- Hill Terrence
- Ho Annie
- Ho Jess
- Ho Jess
- Hobbs Katie
- Hodgson Russell
- Hogan Lucinda
- Hokelekli Furkan
- Hong Jonathan
- Honore Elodie
- Hoosenally Mariyah
- Hopping Eve
- Horsburgh Eleanor
- Hou Lachlan
- Hou Zhen
- House Colin
- How Ming Zhou
- Hsieh Justin
- Hu Nelson
- Huang Dora
- Huang Meileen
- Huang Sarah
- Hui Ally
- Hung Wing
- Husein Abrar
- Hussain Eman
- Hussein Aisha
- Hussien Ahmed
- Hussien Aya
- Hussien Tarek A
- Ibiyemi Femi
- Ibraheem Gbadebo Hakeem
- Ibrahim Abdullahi
- Ibrahim Islam
- Ibrahim Reham
- Ibtisam Muhammad
- Ifoto Oghenekaro
- Iftikhar Hareem
- Imran Aliza
- Incoll Ian
- Innes Michael
- Ioannidis Orestis
- Ioannidis Orestis
- Ioannidis Orestis
- Isaac Hope
- Isah AliyuYabagi
- Isah Dennis Anthony
- Isahak Mohamed Izzad
- Isais Jorge Arath Rosales
- Ismail Samir
- Ismail Tiamiyu
- Isopi Claudio
- Isweesi Mohamed
- Iya Abdulkarim
- Izgis Aylin
- Jaarsma Emily
- Jabur Aiden
- Jabur Aiden
- Jabur Aiden
- Jaffry Kumail
- Jaffry Kumail
- Jakanovski Philip
- Jamal Sami
- Jamali Salma
- Jamieson Jodie
- Jamil Muhammad Badrul Hisyam Mohamad
- Jangam Aishwarya
- Jangra Muskan
- Javed Imran
- Jawa Timothy
- Jayatilleke Shenuka
- Jayyab Mustafa Abu
- Jeffery Fraser
- Jenkins Gregory
- Jeyamohan Ragavi
- Jeyarajan Deepak Rajan
- Jiang Vincent
- Jimenez Ramirez Lia Jasmin
- Jin Rong
- Jinu Puja
- Jollow David
- Joseph Fashe
- Joseph Nejo
- Joshi Divyanshu
- Joshi Krishma
- Ju William
- Juha Nida
- Jurgaitis Jonas
- Just Benjamin
- Juwaheer Ghanisht
- Kaabache Oumelaz
- Kache Stephen Akau
- Kaddah Abdulrahim Al
- Kaiser Nicole
- Kala Bemi
- Kale Ahmet
- Kaleem Urauba
- Kalkan Senad
- Kalogiannidis Ioannis
- Kalyanasundaram Kaviya
- Kamaleldin Aya
- Kamath Aditi
- Kamath Aditi
- Kamel Ali Momen
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- Yuzgec Ayse Nilufer
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- Zaed Moahmed
- Zafar Fatima
- Zaghloul Ahmed
- Zaheer Adil
- Zaidi Faseeh
- Zain Ahmad
- Zakaria Ahmed
- Zakaria Andee Dzulkarnaen
- Zakaria Mohd Zaim
- Zalloum Jihad
- Zamanbandhon Bushra
- Zambon Mattia
- Zapsalis Konstantinos
- Zargar Kamran
- Zarzour Mohamed A
- Zeng Raymond
- Zeng Raymond
- Zengin Kagan
- Zertuche Juventino Tadeo Guerrero
- Zhang Caitlin
- Zhang Edward
- Zhang Shane
- Zhang Yichi
- Zhao Hailin
- Zheng Helen
- Zhou Karen
- Zhou Yida
- Ziergiebel Felix
- Zou Peishan
- Zuylekom Kate Van
- Zuylekom Katie Van
- Zwain Yasir Adnan
- Zyul'korneeva Sof'ya
- Aladna Abdallah
- Aljoumaa Abdullah
- Nawfal Hamdi
- Niazi Ammar
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
Global economic burden of unmet surgical need for appendicitis
- Author
- Aahlin E. K.
- Aamer A.
- Aaniana K.
- Ababneh A.
- Abaliksta T.
- Abantanga F.
- Abbas M.
- Abbasy J.
- Abbo O.
- Abbouch M.
- Abd-Elmawla M.
- Abd-Elrasoul Y.
- Abdallah E.
- Abdel-Aty A.
- Abdel-Hameed N.
- Abdel-Kader S. M.
- Abdel-Wahab N. Y. E.
- Abdelaal A.
- Abdelaty M.
- Abdelazeam A. R.
- Abdelazim G.
- Abdelaziz M. A.
- Abdelbadeai K.
- Abdelfatah A.
- AbdelFattah I.
- Abdelgelil A.
- Abdelghany S.
- Abdelhady S.
- Abdelhamed R.
- Abdelhamid A.
- Abdelhaq A.
- Abdelkader M.
- Abdelkader O.
- Abdelkareem A.
- Abdelkhalek M.
- Abdelmageed E.
- Abdelmotaleb I.
- Abdelraheim M.
- Abdelraouf A. M.
- Abdelrouf D. M.
- Abdelshafy M.
- Abdelshakour M.
- Abdrabou A. K.
- Abdul-Latif S.
- Abdulaziz H.
- Abdulbagi O.
- Abdulgawad M.
- Abdulhakeem E. M.
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- Publication venue
- Oxford University Press
- Publication date
- 01/01/2022
- Field of study
Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
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- A Yacoub M.
- A. Adam M.
- A. Nassar M.
- A. Nemer A.
- Aahlin E. K.
- Ab Rahim M. F.
- Abad Gurumeta A.
- Abad-Motos A.
- Abang Jamari D. Z. H.
- Abantanga F.
- Abarca S.
- Abazid E.
- Abbas A.
- Abbas K.
- Abbas M. M.
- Abbasy J.
- Abbosh A.
- Abd B.
- Abd Karim M. F. S.
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- Abdalei A.
- Abdalla Ahmed Elkamel A.
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- Abdelhady Mousa H.
- Abdelhady S.
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2022
- Field of study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
- Author
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
- Aahlin EK
- Aamer A
- Aaniana K
- Ababneh A
- Abaliksta T
- Abantanga F
- Abantanga F
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- 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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- Atiyeh A
- Atkins ET
- Atkinson K
- Atobatele K
- Attallah NA
- Attard M
- Attia A
- 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
- Azizeldine MG
- Azmitia Mendizabal CA
- Azodo IA
- Azzie G
- Azzie G
- Azzis O
- Baba S
- Bachri H
- Badawy M
- Badenjki MA
- Badicel M
- Badr A
- Badr MFM
- Badwi NM
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- Badwy A
- Bahar S
- Baheeg M
- Bailey K
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- Baird A
- Bakhaidar M
- Baki BE
- Bakr A
- Bakry HM
- Bala M
- Balalis D
- Baldacchino M
- Balducci G
- Balila RMH
- Balkan AZA
- Ballouhey Q
- Balmaceda R
- Balmaceda R
- Balmaceda R
- Balogun F
- Baltrunas R
- Baluch F
- Bamford R
- Bamicha A
- Bamicha A
- Banaitis VJ
- Bandi A
- Bandoh D
- Bani-Sadar A
- Banipal GS
- Baraka H
- Barakat SAE
- Barendegere V
- Barker T
- Barkolias C
- Barmayehvar B
- Barnabas GN
- Barnacle J
- Barneo L
- Barrionuevo Ojeda RR
- Barrios E
- Barrios E
- Barros De Castro Segundo LC
- Barroso de Lima CV
- Barry J
- Basilico S
- Basir ERM
- Bassem M
- Bassit KA
- Basso SMM
- Basson S
- Batt J
- Bayram S
- Beamon M
- Beasley W
- Beaton C
- Bedada AG
- Bediako-Bowan A
- Behar N
- Beisa V
- Beisa V
- Bekhet AH
- Bekhet NM
- Beleno AEM
- Belkouchi A
- Belli A
- Bello B
- Benammi S
- Benevento A
- Benevento A
- Benger M
- Bennai RM
- Benons N
- Bentounsi Z
- Benyaiche C
- Berti S
- Bertuello I
- Beuran M
- Beuran M
- Beyene R
- Bezerra Morais PA
- Bezzina M
- Bhang A
- Bhangu A
- Bhangu A
- Bhargava A
- Bharj IS
- Bhat S
- Bhatnagar A
- Bhattacharya S
- Bhopal KF
- Bhopal KF
- Bianco F
- Bigaran A
- Billy M
- Bin Adnan A
- Bin Hasnan M
- Bin Ismail MJ
- Bin Mahamood A
- Birindelli A
- Birring A
- Bisset C
- Bjorklund I
- Bjorklund I
- Blacker S
- Blackwell J
- Blanco R
- Blanco-Colino R
- Blencowe N
- Blencowe N
- Bliksoen M
- Blower E
- Bluelle R
- Blundell R
- Boakye-Yiadom K
- Boal M
- Bocchetti T
- Boddy A
- Bode C
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- Bodur S
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- Boggon A
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- Bokhari S
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- Bond-Smith G
- Bondin J
- Bondurri A
- Bondurri A
- Boni S
- Bonnard A
- Bonney W
- Borda Luque G
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- Borda-Luque G
- Borg E
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- Borin E
- Bortolasi L
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- Boshnaq M
- Botes S
- Bottini C
- Botto N
- Bouali O
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- Bowe R
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- Bowman C
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- Bradulskis S
- Bratu M
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- Bratu R-M
- Braungart S
- Bray LD
- Breaud J
- Breistrand M
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- Breslin R
- Brincat SD
- Broch A
- Brogden T
- Brown D
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- Brown J
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- Brunoni B
- Bsisu I
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- Bugaev N
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- Burns H
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- Cabala Chiong JA
- Cacurri A
- Cadogan DD
- Cahill R
- Cakaloglu HC
- Caliman C
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- Cameron B
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- Camilleri-Brennan J
- Camilleri-Brennan J
- Camilleri-Brennan JF
- Camilo Correa J
- Campagnaro T
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- Carmela Lapitan M
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- Cassar K
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- Chachulski W
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- Chapman A
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- Chen CY
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- Chen T-L
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- Cheong YJ
- Chetta N
- Cheung YHE
- Chew LS
- Chhabra S
- Chibuye C
- Chidambaram S
- Chiesa D
- Chilton G
- Chin PX
- Chin YR
- Chiu S
- Chiu S
- Chiu SMY
- Choi J
- Choi P
- Chong BFHK
- Chong CL
- Chong CL
- Chong CL
- Chong CS
- Chong H-Y
- Chong HY
- Choudhry A
- Chow CYN
- Chowdhury A
- Chowdhury D
- Chu K
- Chun A
- Chun T
- Chung KJ
- Chung S
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- Clegg-Lamptey J-N
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- Darweesh M
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- De Luca E
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- Decker E
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- Dedey F
- Deichsel F
- Del Basso C
- del Pilar Paucar A
- Delforge X
- Dell A
- Dempster E
- Denakpo M
- Denewar A
- Depalma N
- Deputy M
- Der Y
- Dervenis C
- Despotidis V
- Desta S
- Deutschmann P
- Devadasar GH
- Dharamshi HA
- Dhillon D
- Di Franco F
- Di Martino N
- Di Saverio S
- Di Saverio S
- Diab A
- Diaconescu B
- Diaconescu I-B
- Dias S
- Diaz Vico T
- Diaz-Jover P
- Diaz-Zorrilla C
- Dick L
- Dickfos M
- Dickson L
- Dijan E
- Dimech T
- Din F
- Dindyal S
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- Dione Parreno-Sacdalan M
- Dissanayake T
- Djivoh F
- Domini E
- Domini E
- Donnelly P
- Donoghue D
- Dorani RMNR
- Dorisme A
- dos Santos DV
- Dossou F
- Doughan S
- Doughty J
- Dousset B
- Dragatas D
- Drake TM
- Drake TM
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- Driscoll A
- Drungilas M
- Du Plessis D
- du Plooy F
- Du Toit F
- Duane T
- Dubois A
- Duffy L
- Duhoranenayo D
- Duinhouwer L
- Dulskas A
- Dwydar A
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- Ebrahim OS
- Eduard P
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- El Dahab AA
- El Deen KN
- El Gendy A
- El Gendy NH
- El Halawany M
- El Jamassi A
- El Kashash A
- El Kholy A
- El Magd AA
- El Mesery S
- El Sayed GS
- El Sayed IM
- El Shoura Y
- El-badawy HA
- El-Dien KS
- El-Dien KS
- El-Din RA
- El-Din SA
- El-Gizawy E
- El-Hamouly AS
- El-Kashef H
- El-Latif NK
- El-Ma'doul AS
- El-Rabaa S
- El-Sagheer N
- El-Sawy A
- El-Sehily A
- El-Shahat NS
- El-Sheemy H
- El-Taher E
- Elabdin HZ
- Elashmawy M
- Elashry R
- Elazab A
- Elazayem AA
- Elazoul M
- Elbanby E
- Elbanby ES
- Elbatahgy A
- Elbe P
- Elbermawy M
- Elbisomy KH
- Eldafrawy M
- Eldamaty L
- Eldeeb AZ
- Eldeen EA
- Eldin MAB
- EldosoukyMohammed A
- Elebute O
- Elebute O
- Elena G
- Elfarargy A
- Elfeki H
- Elfeki H
- Elfiky M
- Elfil M
- Elfouly N
- Elfouly N
- Elfouly Y
- Elfouly Y
- Elgebaly A
- Elgendy AH
- Elgendy FI
- Elgheriany M
- Elhadad A
- Elhadary NM
- Elhadry S
- Elhalawany E
- Elhamouly S
- Elhelbawy MS
- Elhendawy A
- Elhendawy AOA
- Elhoseny G
- Elhusseiny AAE
- Elizabeth Lopez C
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
- Elkelany A
- Elkhadrawi M
- Elkhalek EA
- Elkholy A
- Elkholy SS
- Elkolaly SS
- Elkorashy AM
- Ellison Q
- Elmashala A
- Elmasry M
- Elmelegy R
- Elmihy S
- Elnagar A
- Elnajjar MA
- Elnemr AE
- Elrazek AA
- Elsabbagh N
- Elsameea AA
- Elsawahly DME
- Elsawy A
- Elsayed M
- Elsayed M
- Elsayed N
- Elsayed NAR
- Elsayed ZM
- Elsebaaye AO
- Elsehimy M
- Elsemelawy R
- Elshaar M
- Elshaer K
- Elshaer M
- Elshaer M
- Elshafay AE
- Elshami M
- Elshanwany S
- Elsharkawy AA
- Elsheikh S
- Elsherbiney S
- Elsherbiny AS
- 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
- Escalante Salas MDC
- Espin-Basany E
- Espinoza F
- Essam A
- Essam AA
- Essam M
- Essoun S
- Esteban E
- Estee MM
- Estupinian S
- Etchill E
- Etchill E
- Etienne S
- Etman M
- Etwire V
- Evajelista CV
- Evans D
- Evans E
- Eysa A
- Eyssartier E
- Ezzat E
- Ezzat T
- Faboya O
- Faccincani R
- Fadel A
- Fahiem A
- Fahim M
- Fahmy MAB
- Fahy C
- Fairfield C
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- Falaschi F
- Falco N
- Falzon M
- Farag A
- Farag S
- Farah A
- Farahat MM
- Faraz A
- Fares M
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- Farhangmehr N
- Farinella E
- Farmakis K
- Farooq T
- Farouk SAM
- Farquharson A
- Farrugia A
- Farrugia A
- Faruq A
- Fathy AM
- Fattah AA
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe CO
- Fergany A
- Fergusson SJ
- Fergusson SJ
- Fergusson SJ
- Fergusson SJ
- Fermani C
- Fermani CG
- Fernandes C
- Fernandez C
- Fernandez-Bueno F
- Fernandez-Vega L
- Ferousis C
- Ferrero E
- Fievet L
- Filatau A
- Findlay-Cooper K
- Firdouse M
- Firdouse M
- Firdouse M
- Firwana A
- Fitsum A
- Fitzgerald JE
- Fitzgerald JE
- Florez Farfan ES
- Foco M
- Fok CYJ
- Fontana T
- Foo CC
- Forlin L
- Forno W
- Fouad A
- Fouad D
- Fouad D
- Fourcade L
- Fowler AJ
- Fozard T
- Fozard T
- Frade F
- Fraga GP
- Francisco Roxas M
- Franco H
- Francois P
- Francois-Coridon H
- Francone E
- Freitas AV
- Frey D
- Frisk B
- Fuentes-Rivera L
- Fujii F
- Furqan MM
- Gaafar S
- Gaarder T
- Gad A
- Gad MO
- Gadelkarim M
- Gadhvi V
- Gado A
- Gaignard E
- Gaignard E
- Gaizauskas V
- Gala T
- Gala T
- Galiqi G
- Galleano R
- Gallo G
- Galloway S
- Galvez CP
- Gamal D
- Gamal E
- Gamal H
- Gamal S
- Gamaly E
- Gamil D
- Gan C
- Gan YY
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- Garaycochea O
- Garcia Bernardo C
- Garcia Florez LJ
- Garcia Septiem J
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- Germanos S
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- Gerosa A
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- Glover TE
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- Glynn M
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- Grizhja B
- Grobler DC
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- Guevara Torres S
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- Halicioglu I
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- Hashad E
- Hasheminia A
- Hashim A
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- Hassaan A
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- Ibrahim A
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- Imoro O
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- Kotecha D
- Koto MZ
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- Mohammad A
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- Montrimaite M
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- Sakr A
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- Samaraweera DI
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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
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
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- Abbas Sh
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- Abbott T
- Abdelgadir Am
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- Di Gioia P
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- Diaz A
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- Easdon S
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- Edwards Se
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- Eiben P
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- El-Tayar O
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- Elbetti C
- Elgaddal S
- Elia M
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- English Wj
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- Erdas E
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- Fairfield Cj
- Falaschi F
- Falco N
- Fanibi Bf
- Fareleira A
- Farhan-Alanie M
- Farina V
- Faris Ar
- Farrell Sm
- Farrow Ez
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- Farrés R
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- Faulkner G
- Fawzi F
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- Feleppa C
- Feliu F
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- Ferguson N
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- Fernández-Martínez D
- Fernández-Martínez D
- Fernández-Martínez D
- Feroci F
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- Ferrer-Vilela I
- Fijo Lm
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- Finlayson H
- Finotti E
- Fiore L
- Fiorot A
- Flack T
- Fleming Ta
- Fleres F
- Foers W
- Foley Nm
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- Fontaine C
- Fontana T
- Fontani A
- Fooks P
- Foppa C
- Forgie A
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- Fornell-Ariza M
- Forouzanfar A
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- Gammeri E
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- García M
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- García Na
- García V
- García-Carrero M
- García-Catalá L
- García-Catalá L
- García-Granero A
- García-Granero A
- García-Gutierrez C
- García-Novoa A
- García-Novoa A
- García-Pérez Jm
- García-Rivera Co
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- Ghatorae S
- Ghazala R
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- Griffiths Np
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- Grimaldo Eg
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- Guimarães Jm
- Gulamhussein M
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- Gurung S
- Gusai Gp
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- Gómez N
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- Haines S
- Hajibandeh S
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- Hanif Z
- Hanley C
- Hann Aj
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- Harder G
- Hardy E
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- Harries Rl
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- Hawkins W
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- Hernaez A
- Hernandez-Gimenez L
- Hernando A
- Herrod P
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- Hever P
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- Hicks G
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- Hill J
- Hobson Bm
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- Hoff M
- Hollingsworth A
- Hollyman M
- Hollyman M
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- Hornby St
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- Horsfield E
- Howie Ee
- Hraishawi I
- Huang J
- Hudson-Peacock Nj
- Hudson-Peacock Nj
- Hunter I
- Hureibi Ka
- Hureibi Ka
- Hussain A
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- Hussaini Sa
- Hussein A
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- Hutchinson B
- Iannone I
- Ibrahim Y
- Ikram S
- Ilozue T
- Imperatore M
- Inama M
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- Infante H
- Iosif E
- Iqbal Mr
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- Irukulla S
- Irwin R
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- Islam N
- Islam S
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- Julià D
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- Kanakala V
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- Kaubrys M
- Kaur G
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- Kouroumpas E
- Krishnamoorthy A
- Krivan S
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- Shurlock J
- Sian T
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- Siddiqui Mn
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- Zhang Ay
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- Zorrilla L
- Zuin M
- Zurleni Tz
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2019
- Field of study
Background
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified
Mortality of emergency abdominal surgery in high-, middle- and low-income countries
- Author
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- A Abd El Galeel
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- U Gustafsson
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- V Despotidis
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- V Graffeille
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- W S M Kithsiri Janakantha Senanayake
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- 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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- Antoniozzi A
- Anwar Aw
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- Anwer W
- Anyanwu Lj
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- Aonzo P
- Appeadu-Mensah W
- Appiah Ek
- Aql S
- Aquilino F
- Arachchi Pp
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- Arafa O
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- Arango Mcm
- Arango Mcm
- Arango Mcm
- Arango Mcm
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- Araujo Jslr
- Arcudi C
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- Arnaud A
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- Ashour A
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- Awad I
- Awad Sa
- Awadallah S
- Awuku-Asabre J
- Ayad S
- Ayandipo O
- Ayandipo Oo
- Aydin Mc
- Ayyar S
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- Aziz Mra
- Aziz Na
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- Balmaceda R
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- Bamford R
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- Bandoh D
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- Barakat Sae
- Barendegere V
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- Barmayehvar B
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- Barrientos Lam
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- Bassem M
- Bassit Ka
- Basso Sm
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- Batt J
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- Bayram S
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- Bediako-Bowan A
- Behar N
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- Beisa V
- Bekhet Ah
- Bekhet Nm
- Beleñ
- Belkouchi A
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- Benammi S
- Benevento A
- Benevento A
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- Benons N
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- Benyaiche C
- Bermú
- Bernardo Cg
- Berti S
- Bertuello I
- Beuran M
- Beuran M
- Beyene R
- Bezzina M
- Bhangu A
- Bhangu A
- Bhangu A
- Bhangu A
- Bhargava A
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- Bhat S
- Bhatnagar A
- Bhattacharya S
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- Bianco F
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- Chen Cy
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- Chetta N
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- Chibuye C
- Chidambaram S
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- De Franciscis S
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- De La Medina AR
- de Leó
- De Leon MZP
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- de Lima CVB
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- Deichsel F
- Del Basso C
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- Delgado Jm
- Delgado Msftl
- Dell A
- Dempster E
- Denewar A
- Depalma N
- Deputy M
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- Despotidis V
- Desta S
- Deutschmann P
- Devadasar Gh
- Dharamshi Ha
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- Di Martino N
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- Diab A
- Diaconescu B
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- Din F
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- Dissanayake T
- Djivoh F
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- Duinhouwer L
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- El Galeel AA
- El Gendy NH
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- El Jamassi A
- El Kashash A
- El Kholy A
- El Magd AA
- El Mesery S
- El Salam YA
- El Sayed GS
- El Sayed IM
- El Shoura Y
- El Slam MA
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- El-Dien Ks
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- El-Din Ra
- El-Din Sa
- El-Gizawy E
- El-Hamouly As
- El-Kashef H
- El-Latif Nka
- El-Ma&apos
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- El-Sagheer N
- El-Salam Fa
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- El-Shahat Ns
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- Elashmawy M
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- Elazab A
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- Elbatahgy A
- Elbe P
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- Elbisomy Kh
- Eldafrawy M
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- Eldeeb Az
- Eldeen Ea
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- Elebute O
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- Elena G
- Elfarargy A
- Elfeki H
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- Elfiky M
- Elfil M
- Elfouly N
- Elfouly N
- Elfouly Y
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- Elgebaly A
- Elgendy Ah
- Elgendy Fi
- Elgheriany M
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- Elhadry S
- Elhalawany E
- Elhamouly S
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- Elhendawy A
- Elhendawy Aoa
- Elhoseny G
- Elhusseiny Aae
- Elkadsh I
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- Elkelany A
- Elkelany A
- Elkelany A
- Elkelany A
- Elkhadrawi M
- Elkhalek Ea
- Elkholy A
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- Elkolaly Ss
- Elkorashy Am
- Ellison Q
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- Elnajjar Ma
- Elnemr Ae
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- Elsameea Aa
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- Elsherbiny As
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- Elzahed N
- Elzayat I
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- Elzowawi F
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- Escobar Eg.
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- Espinoza F
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- Estupinian S
- Etchill E
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- Etwire V
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- Evans D
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- Faccincani R
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- Farouk Sam
- Farquharson A
- Farrugia A
- Farrugia A
- Faruq A
- Fathy Am
- Fattah Aa
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe Co
- Fergany A
- Fergusson Sj
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- Ibrahim A
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- Ibrahim I
- Ibrahim K
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- Idress T
- Idris F
- Idris Sai
- Iftekhar F
- Iftikhar Z
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- Ignatavicius P
- Ihediwa G
- Imoro O
- Ingabire Jca
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- Ioannidis O
- Iordache Fm
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- Ismail A
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- Ismail Sa
- Israelsson L
- Ivros N
- Iyer D
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- Jabal Ms
- Jabbar A
- Jaber S
- Jackson P
- Jacobe M
- Jaffry Z
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- Jaich R
- Jain P
- Jama Gm
- Jamal L
- Janardha Kc
- Janik M
- Jankus T
- Jaradat D
- Jaramillo Ra
- Jarmin M
- Jasaitis K
- Javaid M
- Javed O
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- Jawaid M
- Jayathilake Ab
- Jck Ng
- Jean-Francois C
- Jeffery A
- Jeffery A
- Jenner E
- Jennings L
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- Jenvey C
- Jeo Ws
- Jeon H
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- Jeyakumar J
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- Jha M
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- Joel Lwl
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- Jokubauskas M
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- Jones C
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- Jotautas V
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- Kaafarani H
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- Kamarulzamil Sna
- Kamil R
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- Karahan Sr
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- Karandikar S
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- Karim A
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- Karismaningtyas H
- Karjiker P
- Karkeet M
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- Karlo R
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- Karousos D
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- Kaselis N
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- Kasem E
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- Kasputyte S
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- Kedar A
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- Keke Kr
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- Kennedy Ed
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- Keogh K
- Kerley R
- Kershaw S
- Kesinger M
- Khafagy T
- Khairy H
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- Khajanchi M
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- Khalifah E
- Khalili M
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- Khallaf S
- Khamajeet A
- Khan A
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- Khan R
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- Khan Za
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- Khatri C
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- Khg Li
- Khoja A
- Khoja A
- Khokha D
- Khokha V
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- Khreishi R
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- Khyrallh A
- Kiasat A
- Kidd T
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- Kim My
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- King R
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- Kinnera Sv
- Kiran Rp
- Kirby A
- Kirishnan A
- Kirupagaran A
- Kiudelis M
- Kjellin A
- Kkk Li
- Klappenbach R
- Knight S
- Koay Kl
- Kobal Bb
- Koh C
- Koh H
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- Koh S
- Koh S
- Kojo Att
- Kojo Att
- Kojo Att
- Kolosov A
- Komolafe O
- Kondrotas P
- Kong C
- Kong Sn
- Kong V
- Kong V
- Konstantina K
- Kontos M
- Kordorwu Hek
- Korkolis D
- Kosai Nr
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- Kose E
- Koskenvuo L
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- Kotb Ahe
- Kotecha D
- Koto Mz
- Kotobi H
- Koumpa F
- Kouraklis G
- Kourdouli A
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- Kretzmann H
- Krishna K
- Kruspi S
- Kufeji D
- Kulasabanathan K
- Kuliavas J
- Kumar B
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- Kumwenda D
- Kushwaha S
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- Kusi K
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- Kwakyeafriyie P
- Kwatiwani C
- Kwizera S
- Kwok Sh
- Kyereh M
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- Kyrou G
- Kyziridis D
- Ló
- L&apos
- La Brocca A
- la Medina AR
- la Medina AR
- la Medina AR
- Labib P
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- Lafferty K
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- Lai Ac
- Lakhani Sm
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- Lando J
- Landolfo G
- Landolfo G
- Lap G
- Lapitan Mc
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- Larsen Jw
- Lasek A
- Lasheen A
- Lasheen Kt
- Latif A
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- Laugzemys E
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- Laurie K
- Lauzikas G
- Law Jh
- Lawal A
- Lawal Ao
- Lawal T
- Lawal Ta
- Lawani I
- Lawther R
- Lazzari G
- Lazzari V
- Leal A
- Leal M
- Lecompte Jf
- Lee C
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- Lee F
- Lee K
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- Leong Fqh
- Leppä
- Leppä
- Leroux J
- Leung Kw
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- Leusink A
- Lewis J
- Li Ws
- Licari L
- Lieske B
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- Liew I
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- Lilford R
- Lilford R
- Lilford Rj
- Lim G
- Lim H
- Lim J
- Lim Pj
- Lim Sj
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- Limaye N
- Limoges B
- Lintin L
- Lipnickas V
- Litvin A
- Liu Q
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- Livesey A
- Livingston M
- Ljuhar D
- Lo Conte A
- Loaloa Mr
- Lockey J
- Lohse Has
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- Loizides S
- Lokman Maa
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- Lopez Ce
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- Lopez M
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- Lorenzon L
- Lossius Wj
- Loughran D
- Low X
- Luc Ar
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- Luglio G
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- Lundgren Po
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- Lytras D
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- Má
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- Ma J
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- Mabrouk M
- Macchiavello R
- Macchitella Y
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- Macdermid E
- Macdonald A
- Macdonald E
- Macdonald L
- Maceviciute K
- Macfarlane A
- Machaca M
- Maciejec L
- Madiba T
- Madkor Mh
- Maffioli A
- Maffioli A
- Magdy A
- Magdy B
- Magdy E
- Magdy H
- Magdy M
- Magdy S
- Magee C
- Maghrabi A
- Maghrabi Aa
- Magri D
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- Maharaj G
- Mahdi A
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- Maher Me
- Mahmoud B
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- Mahmoud M
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- Mahmoud Mi
- Mahmoud S
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- Mahmud K
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- Mairs Ng
- Maison K
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- Makinde M
- Makupe A
- Malavenda M
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- Manatakis Dk
- Manfreda S
- Mangan C
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- Mangiapane M
- Manipal Ce
- Maniscalco A
- Mann T
- Mannu Gs
- Manriquez-Reyes M
- Mansor Ey
- Mansour B
- Mansour S
- Mansuri A
- Mao P
- Mapasse D
- Maple N
- Maraie N
- Marey A
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- Margaritis M
- Mariani A
- Marinkovic B
- Marinos C
- Marks E
- Marples L
- Marret Jb
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- Martian Bv
- Martin A
- Mas R
- Mason C
- Mata Lps
- Matheu A
- Mathew Sw
- Matos-Puig R
- Matta Jjh
- Mattar O
- Matter Sm
- Mauro L
- Mayasari M
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- Mazrimas P
- Mazzella A
- Mcaleer E
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- McGarvie S
- Mcguigan A
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- Mcintyre R
- Mckechnie D
- Mclachlan G
- Mclean Al
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- McMorran D
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- Mejia Agv
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- Mendoza I
- Menegussi J
- Mensah E
- Menshawy A
- Mentula P
- Meqbil J
- Mericliler M
- Merlini D
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- Merlo Ms
- Mesbah N
- Meshref A
- Metwally Mm
- Migliore M
- Miguel Gps
- Mihaljevic Al
- Mihanovic J
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- Mijuskovic B
- Mikalauskas S
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- Mikuckyte D
- Mikwar Z
- Milligan W
- Milligan W
- Mingrone P
- Minguez G
- Minocha A
- Minocha A
- Miranda C
- Mircea H
- Mirghani D
- Mironescu A
- Mironescu A
- Mironescu As
- Mironescu As
- Mirza A
- Mirza S
- Mistry A
- Mitrasinovic S
- Mitroudi M
- Mitroudis N
- Mittal A
- Mitul Ar
- Mitul Ar
- Miyasato Hs
- Mizzi C
- Mizzi S
- Mlotshwa M
- Moaty M
- Mochet S
- Modolo Mm
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- Moe Tt
- Mogan Yp
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- Mohamed A
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- Mohamed Maeh
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- Mohamed O
- Mohamed Sr
- Mohameden A
- Mohammad A
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- Mohammed A
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- Mohammed Ae
- Mohammed Ar
- Mohammed H
- Mohammed Mm
- Mohammed Mmh
- Mohammed S
- Mohan H
- Mohan M
- Mohan M
- Mok Yt
- Mokhtar A
- Molina G
- Mollo Mc
- Monaghan E
- Monaghan E
- Monrad-Hansen Pw
- Montejo Msg
- Monteleone M
- Monteleone M
- Montes I
- Montes I
- Montrimaite M
- Montrimaite M
- Moodley Y
- Moore R
- Moore R
- Mora Jjv
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- Morales C
- Moran Aer
- Morandi E
- Moreira G
- Moreno Sc
- Morgan C
- Morgan C
- Morshedy Em
- Morsi A
- Morsi M
- Morton D
- Morton D
- Morton R
- Mosad A
- Mosalum O
- Mostafa Ha
- Mostafa M
- Mostafa M
- Mousa M
- Moussa O
- Moustafa A
- Mouttalib S
- Mowafy B
- Mphatsoe Am
- Mshelbwala P
- Msiska N
- Msosa V
- Msosa V
- Muddebihal U
- Mukin Adf
- Muktar U
- Mukuzunga C
- Muller C
- Muller C
- Munera A
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- Muntean L
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- Muralha N
- Murphy J
- Murray A
- Murutoglu B
- Musa Aek
- Musleh A
- Musowoya J
- Mussad A
- Mustafa M
- Mustafa M
- Mustafa Ma
- Musyoka Ck
- Mutabazi Az
- Mutabazi Az
- Mutlu D
- Mutlu V
- Muzio E
- Myers J
- Mykoniatis I
- Næ
- Nabawi A
- Nada F
- Nadeem N
- Nadkarni S
- Nagy Gs
- Nahar Sn
- Nair H
- Nanthakumaran S
- Napolitano L
- Napolitano L
- Naqvi Sa
- Naqvi T
- Naranjo Aristizã
- Narayanan R
- Narayanan R
- Narvestad Jk
- Nashaat A
- Nashat M
- Nasher O
- Nashidengo P
- Nasir A
- Nasir Aa
- Nasr A
- Nasr M
- Nasr M
- Nassif D
- Nastri G
- Natalie H
- Nataraja R
- Natili A
- Navarro A
- Nawara C
- Nawawi A
- Nawawi A
- Nayel Ar
- Nazir M
- Ndajiwo A
- Ndajiwo A
- Ndegwa W
- Ndlovu Sr
- Ndwambi P
- Ne&apos
- Negida A
- Negoi I
- Nel D
- Nemeth K
- Neo Yn
- Neo Yt
- Neophytou C
- Nepogodiev D
- Nepogodiev D
- Nepogodiev D
- Nepogodiev D
- Nesaratnam A
- Nessa A
- Nestorovic M
- Nevieraite V
- Newton T
- Ng S
- Ng Yk
- Ng Zh
- Ngayu N
- Ngwa Te
- Niazi Ak
- Nicholson L
- Nighat B
- Nigo S
- Nikberg M
- Nikoloudis N
- Nikoloudis N
- Niragire A
- Niranjan N
- Nirumal Mk
- Niska K
- Nita Ge
- Nita Ge
- Niyirera E
- Njokanma I
- Nnajiuba H
- Nocito A
- Nocito A
- Nofal E
- Noor F
- Normile C
- Normile C
- North As
- Notarnicola M
- Notarnicola M
- Nouh T
- Nouh T
- Noukpozounkou B
- Novak A
- Nowers J
- Nsengimana Vjp
- Nsengiyumva C
- Ntirenganya F
- Nur&apos
- Nurqistan Hd
- Nwabuoku E
- Nwinee V
- Nwokoro C
- Nyberg J
- Nymo L
- O&apos
- O&apos
- O&apos
- O&apos
- O&apos
- O&apos
- Obute Rd
- Occhionorelli S
- Odeyemi B
- Odeyemi B
- Odutola O
- Ogunsua O
- Ogunyemi A
- Oh J
- Oh J
- Ohene-Yeboah M
- Ojeda Rrb
- Okenabirhie O
- Olajide To
- Olaolorun A
- Olivier J
- Olori S
- Olori S
- Oludara M
- Oludara M
- Olugbemi M
- Omar Aa
- Omar Me
- Omar Mfw
- Omara S
- Omer Oa
- Onimowo J
- Onuoha C
- Oosterkamp A
- Opoku-Agyeman R
- Oram S
- Orbegozo Pat
- Orchard M
- Ortega I
- Ortega I
- Ortega-Vazquez I
- Ortiz N
- Orton P
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- Osei-Nketiah S
- Oshati O
- Oshodi O
- Osinowo A
- Osinowo A
- Osman M
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- Osman O
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- Oswald D
- Otero-Dí
- Othman M
- Ots R
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- Oumer R
- Owen C
- Owusu F
- Owusu F
- Ozben V
- Ozkan Bb
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- Ozkan Bb
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- Paž
- Pabla G
- Pacheco Rda
- Padmore G
- Pagano G
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- Pagnozzi J
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- Palliyil M
- Palliyil Mm
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- Palma Af
- Paludi Ma
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- Panez Wr
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- Panteli C
- Papageorgiou D
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- Papandrea M
- Papaskarlatos Ia
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- Parseliunas A
- Parthiban S
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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
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