54 research outputs found
Effectiveness of cyproheptadine in the management of delayed vomiting after cisplatin-based chemotherapy and the assessment of the influence of cyproheptadine on ąuality of life
- Publication venue
- 'Salvia Medical Sciences Ltd'
- Publication date
- 01/01/1970
- Field of study
Zuchtprogramm und zielgesetztes selektionverfahren bei schafzucht in polen
- Author
- Publication venue
- BioMed Central
- Publication date
- 01/01/1980
- Field of study
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The power of the Mediator complex-Expanding the genetic architecture and phenotypic spectrum of MED12 -related disorders
- Author
- Publication venue
- 'Wiley'
- Publication date
- 13/07/2018
- Field of study
MED12 is a member of the large Mediator complex that controls cell growth, development, and differentiation. Mutations in MED12 disrupt neuronal gene expression and lead to at least three distinct X-linked intellectual disability (XLID) syndromes (FG, Lujan-Fryns, and Ohdo). Here we describe six families with missense variants in MED12 (p.(Arg815Gln), p.(Val954Gly), p.(Glu1091Lys),p.(Arg1295Cys), p.(Pro1371Ser) and p.(Arg1148His), the latter being firstly reported in affected females) associated with a continuum of symptoms rather than distinct syndromes. The variants expanded the genetic architecture and phenotypic
spectrum of MED12-related disorders. New clinical symptoms included brachycephaly, anteverted nares, bulbous nasal tip, prognathism, deep set eyes, and single palmar crease. We
showed that MED12 variants, initially implicated in X-linked recessive disorders in males, may predict a potential risk for phenotypic expression in females, with no correlation of the X chromosome inactivation pattern in blood cells. Molecular modeling (Yasara Structure) performed to model the functional effects of the variants strongly supported the pathogenic character of the variants examined. We demonstrated that molecular modeling is a useful method for in silico testing of potential functional effects of MED12 variants and thus can be a valuable addition to the interpretation of the clinical and genetic findings
Mutations in the nuclear localization sequence of the Aristaless related homeobox; sequestration of mutant ARX with IPO13 disrupts normal subcellular distribution of the transcription factor and retards cell division
- Author
- A Hahn
- A Swaroop
- AL DeStefano
- C Laperuta
- C Shoubridge
- Cheryl Shoubridge
- CT Fulp
- DA Keays
- David Coman
- Desiree Cloosterman
- E Berry-Kravis
- E Marsh
- G Binder
- G Tian
- G Uyanik
- GA Rappold
- George McGillivray
- Grazia M Mancini
- H Hartmann
- H Miura
- J Gecz
- J Gecz
- JC Phillips
- JE Ploski
- JM Mingot
- Jozef Gécz
- K Gronskov
- K Kitamura
- K Poirier
- K Poirier
- K Szczaluba
- KM Boycott
- KU Schneider
- LA Mavrogiannis
- M Jagla
- M Kato
- M Kato
- M Nawara
- M Tassabehji
- M Wolf
- May Huey Tan
- MM Troester
- MW Partington
- N Bahi-Buisson
- NK Ragge
- O Reiner
- P Duquesnoy
- P Kalab
- P Stromme
- R Guerrini
- R Perveen
- R Wallerstein
- S Mody
- S Okazaki
- S Rujirabanjerd
- S Vallette-Kasic
- SE Hong
- SJ Lee
- SS Bhat
- T Sapir
- Tjitske Kleefstra
- Tod Fullston
- V des Portes
- VR Harley
- W Lin
- W Wu
- WB Dobyns
- Y Shinozaki
- YI Chi
- Publication venue
- BioMed Central
- Publication date
- 01/01/2010
- Field of study
The electronic version of this article is the complete one and can be found online at: http://www.pathogeneticsjournal.com/content/3/1/1Background: Aristaless related homeobox (ARX) is a paired-type homeobox gene. ARX function is frequently affected by naturally occurring mutations. Nonsense mutations, polyalanine tract expansions and missense mutations in ARX cause a range of intellectual disability and epilepsy phenotypes with or without additional features including hand dystonia, lissencephaly, autism or dysarthria. Severe malformation phenotypes, such as X-linked lissencephaly with ambiguous genitalia (XLAG), are frequently observed in individuals with protein truncating or missense mutations clustered in the highly conserved paired-type homeodomain. Results: We have identified two novel point mutations in the R379 residue of the ARX homeodomain; c.1135C>A, p.R379S in a patient with infantile spasms and intellectual disability and c.1136G>T, p.R379L in a patient with XLAG. We investigated these and other missense mutations (R332P, R332H, R332C, T333N: associated with XLAG and Proud syndrome) predicted to affect the nuclear localisation sequences (NLS) flanking either end of the ARX homeodomain. The NLS regions are required for correct nuclear import facilitated by Importin 13 (IPO13). We demonstrate that missense mutations in either the N- or C-terminal NLS regions of the homeodomain cause significant disruption to nuclear localisation of the ARX protein in vitro. Surprisingly, none of these mutations abolished the binding of ARX to IPO13. This was confirmed by co-immunoprecipitation and immmuno fluorescence studies. Instead, tagged and endogenous IPO13 remained bound to the mutant ARX proteins, even in the RanGTP rich nuclear environment. We also identify the microtubule protein TUBA1A as a novel interacting protein for ARX and show cells expressing mutant ARX protein accumulate in mitosis, indicating normal cell division may be disrupted. Conclusions: We show that the most likely, common pathogenic mechanism of the missense mutations in NLS regions of the ARX homeodomain is inadequate accumulation and distribution of the ARX transcription factor within the nucleus due to sequestration of ARX with IPO13.Cheryl Shoubridge, May Huey Tan, Tod Fullston, Desiree Cloosterman, David Coman, George McGillivray, Grazia M Mancini, Tjitske Kleefstra and Jozef Géc
Structural and Functional Deficits in a Neuronal Calcium Sensor-1 Mutant Identified in a Case of Autistic Spectrum Disorder
- Author
- A Carrie
- A Genin
- A Piton
- B Blasiole
- B Wightman
- BB Kragelund
- BJ Saab
- BW McFerran
- BW McFerran
- DW O'Callaghan
- DW O'Callaghan
- E Aronica
- E Tabolacci
- E Taverna
- E Taverna
- F Gambino
- F Gambino
- H Hui
- J Bai
- J de Barry
- J Jo
- J Lippincott-Schwartz
- J Romero-Pozuelo
- JA Cox
- JA Petko
- JF Presley
- JF Presley
- JL Weiss
- JS Dason
- K Hui
- K-H Braunewell
- Karl-Wilhelm Koch
- KB Hendricks
- Lee P. Haynes
- LP Haynes
- LP Haynes
- LP Haynes
- LP Haynes
- Lu-Yun Lian
- M Bergmann
- M Brackmann
- M Gomez
- M Iketani
- M Mikhaylova
- M Nawara
- M Rajebhosale
- Mark T. W. Handley
- MT Handley
- MTW Handley
- N Bahi
- O Pongs
- P Aravind
- PO Koh
- Q Zheng
- RD Burgoyne
- RD Burgoyne
- Robert D. Burgoyne
- SS Bhat
- T Kawasaki
- T Sippy
- T Tsujimoto
- T Yoshida
- TP Levine
- TY Nakamura
- V Munoz
- W Boehmerle
- X Gao
- X Zhao
- X-L Chen
- Y Bourne
- YH Zhang
- Publication venue
- Public Library of Science
- Publication date
- 01/01/2010
- Field of study
Neuronal calcium sensor-1 (NCS-1) is a Ca2+ sensor protein that has been implicated in the regulation of various aspects of neuronal development and neurotransmission. It exerts its effects through interactions with a range of target proteins one of which is interleukin receptor accessory protein like-1 (IL1RAPL1) protein. Mutations in IL1RAPL1 have recently been associated with autism spectrum disorders and a missense mutation (R102Q) on NCS-1 has been found in one individual with autism. We have examined the effect of this mutation on the structure and function of NCS-1. From use of NMR spectroscopy, it appeared that the R102Q affected the structure of the protein particularly with an increase in the extent of conformational exchange in the C-terminus of the protein. Despite this change NCS-1(R102Q) did not show changes in its affinity for Ca2+ or binding to IL1RAPL1 and its intracellular localisation was unaffected. Assessment of NCS-1 dynamics indicated that it could rapidly cycle between cytosolic and membrane pools and that the cycling onto the plasma membrane was specifically changed in NCS-1(R102Q) with the loss of a Ca2+ -dependent component. From these data we speculate that impairment of the normal cycling of NCS-1 by the R102Q mutation could have subtle effects on neuronal signalling and physiology in the developing and adult brain
Global economic burden of unmet surgical need for appendicitis
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- 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.
- Abdullah M. A.
- Abdullah N.
- Abdullah N. A. N.
- Abdullahi L.
- Abdurrazzaaq A.
- Abebe N. S.
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- Abem O. E.
- Abiola O.
- Aboarab A.
- Aboelella M.
- Aboelmagd O.
- Aboelsoud M. R.
- Aboraya M.
- Aboraya M.
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- Aboul-Naga M. S.
- Abouzahra A.
- Abouzaid A.
- Abozaid M.
- Abozeid K.
- Abozyed M. A. F.
- Abu-Toyour M.
- Abubakr M.
- Abudeeb H.
- Abuowda Y.
- Abuqwaider E.
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- Abuseif 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
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
- Author
- Abantanga F
- Abbas M
- Abbo O
- Abd El Galeel A
- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elrasoul Y
- Abdallah E
- Abdel-Wahab NYE
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelkader M
- Abdelkareem A
- Abdelraheim M
- Abdelshafy M
- Abdulgawad M
- Abdullah AAN
- Abdullah NAN
- Abebe NS
- Abebe NS
- Aber A
- Abington E
- Aboarab A
- Aboraya M
- Aboraya M
- Abouelnasr A
- Abouzahra A
- Abozaid M
- Abozeid K
- Abozyed MAF
- Abudeeb H
- Abuseif M
- Acharya P
- Adams R
- Adebanjo A
- Adekoya A
- Adel A
- Adel A
- Ademuyiwa A
- Ademuyiwa AO
- Adeniran J
- Adeniyi A
- Adesanya O
- Adesina A
- Adesuyi A
- Adeyeye A
- Adham W
- Afandy A
- Afifi AM
- Afzal M
- Agalianos C
- Agarwal A
- Agius M
- Aguilar-Jimenez J
- Aguilera M
- Aguilera O
- Ahlqvist S
- Ahmed A
- Ahmed EA
- Ahmed H
- Ahmed SM
- Aigrain Y
- Ajao AE
- Akeel N
- Akhtar M
- Al Awwad S
- Al-Aarag AA-R
- Al-Azraqi IAA
- Al-Faifi JJ
- Al-Hameedi HII
- Al-Hasani RKMJ
- Al-Mallah A
- Al-Mousa M
- Al-Nahrawi S
- Al-Obaedi O
- Al-shammari A
- Alahmady O
- Alakaloko F
- Alamoudi U
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- Aldalaq A
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- Aledrisy M
- Alfarsi MA
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- Youssef H
- Youssif JH
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- Zardab A
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- Zerihun AB
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- Zuber M
- 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
- Abbas A
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- Abbasy J
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- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elmawla M
- Abd-Elrasoul Y
- Abdallah E
- Abdallah E
- Abdel-Aty A
- Abdel-Hameed N
- Abdel-Kader SM
- Abdel-Wahab NYE
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- Abdelfatah A
- AbdelFattah I
- Abdelgelil A
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- Abdelhady S
- Abdelhamed R
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- 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
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- Faraz A
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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
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- Fermani C
- Fermani CG
- Fernandes C
- Fernandez C
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- Ferousis C
- Ferrero E
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- Filatau A
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- Fitsum A
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- Florez Farfan ES
- Foco M
- Fok CYJ
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- Fouad D
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- Fowler AJ
- Fozard T
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- Frade F
- Fraga GP
- Francisco Roxas M
- Franco H
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- Francois-Coridon H
- Francone E
- Freitas AV
- Frey D
- Frisk B
- Fuentes-Rivera L
- Fujii F
- Furqan MM
- Gaafar S
- Gaarder T
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- Gad MO
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- Gadhvi V
- Gado A
- Gaignard E
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- Gaizauskas V
- Gala T
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- Galiqi G
- Galleano R
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- Galvez CP
- Gamal D
- Gamal E
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- Garaycochea O
- Garcia Bernardo C
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- Germanos S
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- Gerosa A
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- Ghaben A
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- Halicioglu I
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- Mohamed I
- Mohamed M
- Mohamed MA
- Mohamed MAEH
- Mohamed MM
- Mohamed O
- Mohamed SR
- Mohameden A
- Mohammad A
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- Mohammed A
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- Mohammed S
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- Monteleone M
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- Montes I
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- Montoya Botero JA
- Montrimaite M
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- Moodley Y
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- Mosalum O
- Mostafa HA
- Mostafa M
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- Mousa M
- Moussa O
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- Mshelbwala P
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- Mutlu V
- Muzio E
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- Nanthakumaran S
- Napolitano L
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- Naqvi SA
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- Naranjo Aristizaibal FA
- Narayanan R
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- Nataraja R
- Natili A
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- Nazir M
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- Ndegwa W
- Ndlovu SR
- Ndwambi P
- Negida A
- Negoi I
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- Neo YN
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- Nepogodiev D
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- Nessa A
- Nestorovic M
- Nevieraite V
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- Ngwa TE
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- Niyirera E
- Njokanma I
- Nnajiuba H
- Nocito A
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- Nofal E
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- Noukpozounkou B
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- Nowers J
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- Nurqistan HD
- Nwabuoku E
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- Nyberg J
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- Palomino Castillo VD
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- Pesenti G
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- Picciariello A
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- Qureshi AU
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- Samalavicius NE
- Samaraweera DI
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- Zanini N
- Zapata Ponze De Leon M
- Zapata Ponze De Leon M
- Zapata F
- Zarb C
- Zardab A
- Zegarra S
- Zeidan S
- Zelada Alvarez II
- Zerihun AB
- Zeta Solis LA
- Zhang Z
- Zheng F
- Zidan H
- Zidan H
- Zidan M
- Zielinski M
- Ziff O
- Zikry M
- Zil-E-Ali A
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskiene R
- Zilinskiene R
- Zimmermann EF
- Ziubryte G
- Zohair A
- Zorrilla CD
- Zuber M
- Zuber M
- Zuk G
- Zulkifli A
- Zumbuhl L
- Publication venue
- Publication date
- 15/10/2018
- Field of study
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
Mortality of emergency abdominal surgery in high-, middle- and low-income countries
- Author
- A A Ahmed Ata
- A A Ibrahem
- A A Maghrabi
- A A Nasir
- A A Ne'ma Abdullah
- A Abd El Galeel
- A Abdel-Rahman Al-Aarag
- A AbdelFattah
- A Abdelgelil
- A Abdelkareem
- A Abdelmotaleb Ghazy
- A Aber
- A Abo El Magd
- A Abo Elazayem
- A Aboarab
- A Abouelnasr
- A Abouzahra
- A Adebanjo
- A Adekoya
- A Adel
- A Adel
- A Ademuyiwa
- A Adeniyi
- A Adesina
- A Adesuyi
- A Adeyeye
- A Afandy
- A Agarwal
- A Ahmed
- A Al-Mallah
- A Al-Shammari
- A Aldalaq
- A Ali
- A Ali
- A Alkammash
- A Allegri
- A Almallah
- A Almoflihi
- A Alrifaie
- A Altaf
- A Altamimi
- A Althwainy
- A Arenas
- A Ashton
- A Atef Omar
- A Austraite
- A B Zerihun
- A Badr
- A Badwy
- A Baird
- A Bamicha
- A Benevento
- A Bhangu
- A Bhargava
- A Birring
- A Boddy
- A Bondurri
- A Bonnard
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- A Echevarria Rosas Moran
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- N Abd El Hamid
- N Ahmed Attallah
- N Akeel
- N Badwi
- N Behar
- N Benons
- N Blencowe
- N Botto
- N Bugaev
- N D'aguzan
- N Elfouly
- N Elsayed
- N F Watson
- N Ghandora
- N Gobin
- N Gouvas
- N Green
- N Gyanchandani
- N Hall
- N Harrison
- N Herrera
- N J Hall
- N J Smart
- N J Wright
- N Kaselis
- N Limaye
- N M Urbina Rojas
- N Maple
- N Mcintyre
- N Mendez
- N Muralha
- N Ngayu
- N Nikoloudis
- N Osman
- N Panait
- N Pezelj
- N Phillips
- N R Kosai
- N Robertson
- N S Abebe
- N S Mitroudis
- N Sadig
- N Seyoum Abebe
- N Sishuba
- N Soltani
- N Soubhy El-Shahat
- N Starr
- N Yosri Elsayed Abdel-Wahab
- N Zanini
- O Abbo
- O Adesanya
- O Aguilera
- O Al-Obaedi
- O Alahmady
- O Algohary
- O Azzam
- O Bouali
- O Elebute
- O Faturoti
- O Garaycochea
- O Javed
- O Javed
- O Komolafe
- O Mohamed
- O Mosalum
- O Nasher
- O O Ayandipo
- O Oshodi
- O Osman
- O Saadeldeen Ebrahim
- O Salah
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- O Sherief Abd El Hameed
- O Taiwo
- O Todd
- O Warren
- O Wiliams
- O Ziff
- P A Assouto
- P Acharya
- P Alves Bezerra Morais
- P C Munipalle
- P Capleton
- P Danelli
- P De Bono
- P Eduard
- P Harbord
- P Harrison
- P Holton
- P J Lim
- P Jackson
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- P Kielty
- P Labib
- P Malik
- P Mentula
- P Paolo Grandinetti
- P Patel
- P Pitigala Arachchi
- P Ramazzini
- P Sarmah
- P Silvani
- P Singh
- P Sodde
- P Stassen
- P Sutton
- P Sutton
- P Thomson
- P Ugalde
- P Weber
- P Weber
- P Witherspoon
- P-O Lundgren
- Q Alimi
- Q Alimi
- R Adams
- R Allott
- R Alvarado Jaramillo
- R Alyami
- R Alyami
- R Amandito
- R Anderson
- R Araujo
- R Ardley
- R Balmaceda
- R Barrionuevo Ojeda
- R Beyene
- R Blundell
- R Bowe
- R Bugeja
- R Cahill
- R Camacho
- R Chenn
- R Cirocchi
- R Coasaca Huaraya
- R Coomber
- R D Obute
- R D S Omara
- R D'cruz
- R Darío Arias Pacheco
- R Davenport
- R Dean
- R Elmelegy
- R F Staerkle
- R Faccincani
- R Fakher
- R George
- R Gilbert
- R Goh Ern Tze
- R Gratton
- R Guevara
- R Harrison
- R K M Jawad Al-Hasani
- R Kamil
- R Karlo
- R Kennedy
- R Kerley
- R King
- R Lages Simoes
- R Lawther
- R Lilford
- R M H Balila
- R Macchiavello
- R Mcdonald
- R Mcintosh
- R Mcintyre
- R Melo
- R Moore
- R Morton
- R Osuoji
- R Oumer
- R Pranevicius
- R Rackauskas
- R Rajan
- R Rakauskas
- R Riauka
- R Rivas
- R Rodríguez-Uría
- R Sakr
- R Satoskar
- R Schmid
- R Shah
- R Shaker
- R Shaker
- R Slade
- R Soley
- R Som
- R Spence
- R Thurairaja
- R Tyler
- R Villa
- R W Gilbert
- R Zilinskiene
- R-M Bratu
- S A Alnuqaydan
- S A Durand
- S Abd Elmageed Barakat
- S Abdelghany
- S Abdoun Ishag Idris
- S Ahlqvist
- S Al Awwad
- S Al-Nahrawi
- S Aldhafeeri
- S Aljohani
- S Almuallem
- S Altaf Naqvi
- S Anderson Khouri Ferreira
- S Antar
- S Aql
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- S Ayad
- S Ayyar
- S B Shu Yip
- S Basson
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- S Bhat
- S Bhattacharya
- S Binna Kim
- S Bokhari
- S Botes
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- S Braungart
- S Breitenstein
- S Chhabra
- S Chidambaram
- S Chiu
- S Chung
- S Corro-Diaz Gonzalez
- S Cucumazzo
- S Das
- S Desta
- S Di Saverio
- S Dias
- S Dindyal
- S Doughan
- S El Mesery
- S El-Rabaa
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- S Elsheikh
- S Elsobky
- S Estupinian
- S F Ashraf
- S Fergusson
- S G Gosling
- S Galloway
- S Germanos
- S Ghanem
- S Giuliani
- S Gokani
- S Gosling
- S Hafiz
- S Haines
- S Hallam
- S Hassan
- S Highcock
- S Hossaini
- S Hussein
- S Irtan
- S Itopa Suleiman
- S J Chapman
- S J Lim
- S Juciute
- S K D'amours
- S K Pitt
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- S Khan
- S Kharsa
- S King
- S Koh
- S Kruspi
- S Kumar
- S Kushwaha
- S Limache
- S Loizides
- S M Contreras Mérida
- S M Lakhani
- S M Sundstrom
- S Magdy Ahmed
- S Mahdi
- S Man Yeng Chiu
- S Mcaleer
- S Mehrez
- S Mikalauskas
- S Mitrasinovic
- S Mouttalib
- S Nadkarni
- S Ng
- S Nigo
- S O'Neill
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- S Pai
- S Parthiban
- S Ramzi
- S Ray
- S Rayne
- S Razmdjou
- S Roncali
- S Roy
- S S Prasad
- S Saad
- S Said Elkolaly
- S Samy
- S Sani Ali
- S Sarsik
- S Sarwary
- S Satoskar
- S Shaikh
- S Shehata
- S Sheth
- S Shu
- S Sierra
- S Singh
- S Sinha
- S Sivaganesh
- S Stock
- S Tabiri
- S Talukder
- S Talukder
- S Tewari
- S Tharmalingam
- S Tou
- S V Kinnera
- S Vivekanantham
- S Ward
- S Wondimu
- S Zegarra
- S Zeidan
- S-H Kim
- S-P Hosein
- T A M Malik
- T Akeem Lawal
- T Alzayat
- T Arulampalam
- T B Wold
- T Barker
- T Boyce
- T Brogden
- T Chun
- T Clark
- T E Glover
- T Ebogo Ngwa
- T F Jones
- T Falconer Hall
- T Farooq
- T Fautz
- T Fernandes Giuriato
- T Fozard
- T Fozard
- T Khan
- T Kumar
- T M Drake
- T Mak
- T Muhammad Yaseen
- T Naqvi
- T Newton
- T Nouh
- T O'Connor
- T Pezas
- T Poskus
- T Razek B Marinkovic
- T S Hettiarachchi
- T Sherman
- T Stasinou
- T Urbonas
- T W Tilston
- T White
- T Xerri
- T Yaseen
- U Alamoudi
- U Gunnarsson
- U Gustafsson
- U Hantour
- U Karabacak
- U Walsh
- V Ambrozeviciute
- V Beisa
- V D Palomino Castillo
- V Despotidis
- V Gadhvi
- V Graffeille
- V Graffieille
- V Grassi
- V J P Nsengimana
- V Jennings
- V Jotautas
- V K Proctor
- V Kong
- V M Quintero Riaza
- V Parent
- V Patel
- V Punja
- V Sallinen
- V Shatkar
- V Summerour
- V Thanusan
- W Adham
- W Anwer
- W Beasley
- W C Ho
- W C Soon
- W Chachulski
- W Forno
- W Guo
- W Hawkins
- W Ho
- W Hutch
- W J Lossius
- W L Messa Aguilar
- W L Messa Aguilar
- W Milligan
- W Milligan
- W Pino
- W S Li
- W S M Kithsiri Janakantha Senanayake
- Y Abd El Salam
- Y Abd Elrasoul
- Y Abd-Elrasoul
- Y Aigrain
- Y Cengiz
- Y El Shoura
- Y Elfouly
- Y Hegazy
- Y Ibrahim
- Y Imorou Souaibou
- Y Macchitella
- Y N Neo
- Y P Mogan
- Y Rajjoub
- Y Reddy
- Y Salama
- Y Sinha
- Z Chan
- Z Dambrauskas
- Z Hassan
- Z Iftikhar
- Z Jaffry
- Z Mikwar
- Z Oof
- Z Urniezius
- Z Zhang
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2016
- Field of study
Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).
Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.
Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days.
Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
- Author
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- Aamer A
- Aaniana K
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- Abaliksta T
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- Abantanga F
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- Abbasy J
- Abbo O
- Abbo O
- Abbott T
- Abbouch M
- Abd-Elmawla M
- Abd-Elrasoul Y
- Abdallah E
- Abdallah E
- Abdel-Aty A
- Abdel-Hameed N
- Abdel-Kader Sm
- Abdel-Wahab Nye
- Abdelaal A
- Abdelaty M
- Abdelazeam Ar
- Abdelazim G
- Abdelaziz Ma
- Abdelbadeai K
- Abdelfatah A
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelhady S
- Abdelhamed R
- Abdelhamid A
- Abdelhaq A
- Abdelkader M
- Abdelkader M
- Abdelkader O
- Abdelkareem A
- Abdelkhalek M
- Abdelmageed E
- Abdelmotaleb I
- Abdelraheim M
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- Abdelrouf Dm
- Abdelshafy M
- Abdelshakour M
- Abdrabou Ak
- Abdul-Latif S
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- Abdulgawad M
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- Adeniyi A
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- Adesina A
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- Araujo Jslr
- Arcudi C
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- Clegg-Lamptey Jn
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- De La Medina AR
- de Leó
- De Leon MZP
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- Delgado Msftl
- Dell A
- Dempster E
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- Devadasar Gh
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- Domini E
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- El Sayed IM
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- El-Ma&apos
- El-Rabaa S
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- Elkorashy Am
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- Elrasoul Ya
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- Elshobary M
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- Fattah Aa
- Fatuga A
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- Faturoti O
- Faure A
- Fautz T
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- Feidantsis T
- Felipe Co
- Fergany A
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- Fermani C
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- Fowler Aj
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- Frade F
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- Ibrahem Aa
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- Kyriazanos I
- Kyrou G
- Kyziridis D
- Ló
- L&apos
- La Brocca A
- la Medina AR
- la Medina AR
- la Medina AR
- Labib P
- Ladukas A
- Lafferty K
- Lagunavicius K
- Lai Ac
- Lakhani Sm
- Lakshmi Hn
- Lam Fy
- Lam Jcy
- Lam Wh
- Lamanna Gl
- Lanau Miv
- Lando J
- Landolfo G
- Landolfo G
- Lap G
- Lapitan Mc
- Lapitan Mc
- Larsen Jw
- Lasek A
- Lasheen A
- Lasheen Kt
- Latif A
- Laufer Lav
- Laugzemys E
- Laugzemys E
- 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
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- Lee Kc
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- Lee Tsb
- Lemaire Sb
- Leone N
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- Leppä
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- 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
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- Lim G
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- Lim J
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- Lim Sy
- Limache S
- Limaye N
- Limoges B
- Lintin L
- Lipnickas V
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- Livesey A
- Livingston M
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- Lo Conte A
- Loaloa Mr
- Lockey J
- Lohse Has
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- Loizides S
- Lokman Maa
- Longstaff L
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- Lorenzon L
- Lossius Wj
- Loughran D
- Low X
- Luc Ar
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- Mabrouk M
- Macchiavello R
- Macchitella Y
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- Macdonald A
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- 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
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- Magee C
- Maghrabi A
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- Maharaj G
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- Mahmoud B
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- Mangan C
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- Maniscalco A
- Mann T
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- Manriquez-Reyes M
- Mansor Ey
- Mansour B
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- Mansuri A
- Mao P
- Mapasse D
- Maple N
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- Marey A
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- Margaritis M
- Mariani A
- Marinkovic B
- Marinos C
- Marks E
- Marples L
- Marret Jb
- Marshall Dc
- Martian Bv
- Martin A
- Mas R
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- Matheu A
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- Matos-Puig R
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- Mentula P
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- Milligan W
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- Miranda C
- Mircea H
- Mirghani D
- Mironescu A
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- Mirza A
- Mirza S
- Mistry A
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- Mitroudi M
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- Modolo Mm
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- Modolo Mm
- Moe Tt
- Mogan Yp
- Moghazy Me
- Mohamed A
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- Mohamed Am
- Mohamed Ar
- Mohamed B
- Mohamed F
- Mohamed I
- Mohamed M
- Mohamed Ma
- Mohamed Maeh
- Mohamed Mm
- Mohamed O
- Mohamed Sr
- Mohameden A
- Mohammad A
- Mohammad A
- Mohammed A
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- Mohammed Ae
- Mohammed Ar
- Mohammed H
- Mohammed Mm
- Mohammed Mmh
- Mohammed S
- Mohan H
- Mohan M
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- 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
- Morais Pab
- Morales C
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- Morandi E
- Moreira G
- Moreno Sc
- Morgan C
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- Morsi A
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- 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
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- Muddebihal U
- Mukin Adf
- Muktar U
- Mukuzunga C
- Muller C
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- Munera A
- Munhoz Mm
- Munipalle Pc
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- Muralha N
- Murphy J
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- Musa Aek
- Musleh A
- Musowoya J
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- Musyoka Ck
- Mutabazi Az
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- Mutlu D
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- Muzio E
- Myers J
- Mykoniatis I
- Næ
- Nabawi A
- Nada F
- Nadeem N
- Nadkarni S
- Nagy Gs
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- Nair H
- Nanthakumaran S
- Napolitano L
- Napolitano L
- Naqvi Sa
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- Naranjo Aristizã
- Narayanan R
- Narayanan R
- Narvestad Jk
- Nashaat A
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- Nasher O
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- Nasir A
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- Nasr A
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- Nassif D
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- Natalie H
- Nataraja R
- Natili A
- Navarro A
- Nawara C
- Nawawi A
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- Nayel Ar
- Nazir M
- Ndajiwo A
- Ndajiwo A
- Ndegwa W
- Ndlovu Sr
- Ndwambi P
- Ne&apos
- Negida A
- Negoi I
- Nel D
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- 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
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- Nicholson L
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- Nikoloudis N
- Nikoloudis N
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- Njokanma I
- Nnajiuba H
- Nocito A
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- Nofal E
- Noor F
- Normile C
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- Notarnicola M
- Notarnicola M
- Nouh T
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- 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
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- Obute Rd
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- Odeyemi B
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- Odutola O
- Ogunsua O
- Ogunyemi A
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- Olajide To
- Olaolorun A
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- Olori S
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- Oludara M
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- Olugbemi M
- Omar Aa
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- Oosterkamp A
- Opoku-Agyeman R
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- Ortiz N
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- Oshati O
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- Owusu F
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- Ozben V
- Ozkan Bb
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- Pabla G
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- Padmore G
- Pagano G
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- Pagnozzi J
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- Palma Af
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- Papaskarlatos Ia
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- Parseliunas A
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- Pastora J
- Pata D
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- Patoulias I
- Paul M
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- Pino W
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- Pozo Dar
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- Preckailaite E
- Primavesi F
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- Pronin S
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- Puma Cmh
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- Raza A
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- Redota Map
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- Runigamugabo E
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- Salama M
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- Sallinen V
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- Salma M
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- Salma U
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- Sam Zh
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- Samaniego Cs
- Samaraweera Di
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- Sammarco G
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- Sampson C
- Samson G
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- Sanz S
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- Sarafilovic H
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- Saravia F
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- Sasia D
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- Schivo D
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- Semeda N
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- Senanayake Kj
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- Senanayake W
- Septiem Jg
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- Shah A
- Shah J
- Shah R
- Shaharuddin S
- Shahbaz Ar
- Shaheen A
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- Shahzad N
- Shaikh N
- Shaikh S
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- Shalabi A
- Shalaby A
- Shalaby M
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- Shamasneh A
- Shamsedine Aw
- Shamsi G
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- Shariffuddin Am
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- Sharpin C
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- Shaw Ca
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- Shawqi M
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- Shehata S
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- Sherman T
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- Sheta A
- Sheth S
- Shillito S
- Shimy G
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- Sholadoye T
- Shrimanker N
- Shu S
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- Shukla J
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- Sieda B
- Sierra S
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- Siguantay M
- Sigurdadottir J
- Sii Ssy
- Sila Gcm
- Sila Gm
- Sila Gm
- Sileri P
- Silvani P
- Silvestri V
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- Simoes Rl
- Simutis G
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- Sinha Y
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- Sivaganesh S
- Skardž
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- Sleem As
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- Smart Nj
- Smedley A
- Smith C
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- Smith D
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- Snyder E
- Sobnach S
- Sodde P
- Soeselo Da
- Sokratous A
- Solaini L
- Soldevila-Verdeguer C
- Soley R
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- Soliman N
- Soliman Na
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- Solis Laz
- Sollazzo V
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- Souaibou Yi
- Souaibou Yi
- Soulou V
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- Spence R
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- Srinivasan R
- Sriram A
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- Suarez A
- Suarez Aab
- Subocius A
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- Summerour V
- Sund M
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- Sundstrom Sm
- Suresh S
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- Sutton P
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- Sykes M
- Szczap A
- Szeto Ccl
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- Tackie E
- Taddei A
- Tade A
- Tafazal H
- Taha Ems
- Tahboub H
- Taher Aa
- Taher M
- Taher Mm
- Taieb C
- Taiwo A
- Taiwo O
- Taiwo O
- Talaat M
- Tale F
- Tale L
- Talukder S
- Talukder S
- Talving P
- Talving P
- Tammam A
- Tan C
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- Tan Yk
- Tan Yw
- Tanase A
- Tanase A
- Tang A
- Tang L
- Tani Si
- Tansoker I
- Tarek A
- Tarek A
- Tarek D
- Targa S
- Tariq S
- Tata Md
- Tatagiba Ls
- Tawfik Ba
- Tawfik G
- Tawfik G
- Taylor F
- Teasdale E
- Teasdale E
- Teasdale E
- Teasdale E
- Tedeschi U
- Tedjaatmadja C
- Telfah Mm
- Tembo T
- Temoche E
- Tennakoon A
- Teo Sy
- Ter Ez
- Tessera G
- Teufelberger G
- Tew Yy
- Tew Yy
- Tewari S
- Th&apos
- Thabet W
- Thalgaspitiya Spb
- Tham Jc
- Thanusan V
- Tharmalingam S
- Theodosopoulos T
- Thollot A
- Thomas E
- Thompson B
- Thomson P
- Thorarinsdottir H
- Thorarinsdottir H
- Thorell A
- Thorell A
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- Thurairaja R
- Ticona Wa
- Tierney G
- Tilston Tw
- Timothy Ok
- Ting Jrs
- To K
- To K
- Todd O
- Toeema Ag
- Tolba H
- Tolg C
- Tolonen M
- Tolotra Tec
- Tori Sa
- Torrance Hd
- Torrance Hd
- Torres Cpg
- Torres Sg
- Toto Ö
- Tou S
- Townsend D
- Tracy J
- Trompetto M
- Tselos A
- Tshisola Sk
- Tugnoli G
- Tugnoli G
- Tun Ak
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- Turati L
- Turkustani S
- Turner M
- Tutino R
- Tverskis Z
- Tyler R
- Tyler R
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- Ubhi Hk
- Ubiali P
- Ugalde P
- Ukwenya Y
- Uluş
- Ulusahin M
- Upadhyaya V
- Upchurch E
- Urbanavicius L
- Urbonas T
- Urbonas T
- Urniež
- Urniezius Z
- Urquizu Mc
- Usaityte A
- Utter M
- Uzabumwana N
- Vaicius A
- Valcarcel-Saldañ
- Valioulis I
- Van Der Naald N
- Van Duren B
- Van Niekerk M
- Van Straten S
- Varcada M
- Vargas M
- Varkalys K
- Vartanoglu T
- Vartic M
- Vartic M
- Vasquez G
- Vasquez I
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- Venugopal C
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- Vianna P
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- White T
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- Woin E
- Wold Tb
- Wolf B
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- Wong Cs
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- Wood G
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- Wright N
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- Yifieyeh A
- Yildirim R
- Yip C
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- Younis A
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- Youssif Jh
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- Zaa&apos
- Zachariades Dc
- Zadoroznas A
- Zahran D
- Zakaria E
- Zakaria M
- Zakaria Y
- Zaki A
- Zakir M
- Zalabia Mf
- Zamarin K
- Zammit S
- Zampitis N
- Zani A
- Zani A
- Zani A
- Zanini N
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- Zapata F
- Zarb C
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- Zegarra S
- Zeidan S
- Zerihun Ab
- Zhang Z
- Zheng F
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- Publication venue
- 'Wiley'
- Publication date
- 27/11/2018
- Field of study
Background
End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection.
Methods
This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model.
Results
In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001).
Conclusion
Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
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