5 research outputs found
Panamá y Colombia: análisis comparativo del sector de perfumes y cosméticos
- Publication venue
- Publication date
- 01/01/2018
- Field of study
En el presente artículo de reflexión se abordan distintos temas que permiten conocer y comprender el comportamiento del sector de perfumería y cosméticos en Panamá y Colombia, donde principalmente, se realiza la respectiva descripción del sector objeto de estudio, en el cual se detallan los principales países consumidores y/o proveedores de esta clase de productos. Seguido a esto, se exponen las políticas comerciales de Panamá, las cuales dan a conocer el estado del país en temas de desarrollo y estabilidad económica, tomando como referente, los exámenes de políticas comerciales realizados por la Organización Mundial del Comercio. Por último, se elabora un análisis DOFA del sector y de los países, donde se indican estrategias para fortalecer el mercado panameño, de igual forma, se expresan observaciones en relación al sector en Colombia, las cuales se pueden aplicar para realizar cambios y ajustes positivos, que permitan ampliar la internacionalización de los productos de perfumería y cosméticos
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
- Author
- A. Mohammed Kalakwa
- A. Nemer Ayoub
- Abantanga Francis A.
- Abatli Safa' Jamal
- Abbas Wisam
- Abbo Olivier
- Abdelbaqi Reem
- Abdelhady Dina Sobhy
- Abdelhafez Mohammad Omar Mohammad
- Abdelhamid Sultan S.
- Abdelmaksoud Sherif
- Abdelmoumen Roua
- Abdelmutalib Fakereldeen
- Abdul-Mumin Alhassan
- Abduljawad Fatima Mousa
- Abdullah Fizan
- Abdullah Mohd Yusof bin
- Abdulraheem Nurudeen
- Abdulrahman Alaa
- Abdulsalam Moruf Adekunle
- Abdunomonovich Dekhkonboev Avazjon
- Aboelela Ahmed
- Abouheba Mohamed
- Abrahamsson Kate
- Abrunhosa Matias Marcia
- Abu-Nejmah Fawzi
- Abuajaila Abdulsalam
- Abuattaya Adham Ashraf
- Abubakar Auwal M
- Abueideh Ahmad
- Abuhayyeh Husam Aldean
- Abuhlega Ma'aly A.
- Abukhalaf Sadi
- Abumunshar Ali Abdelhay
- Acuna Gaston
- Adams Stephen
- Adamu Sani
- Adanan Mohd Fitri Shukri bin Mohamed
- Adawi Ihda
- Adawi Samer
- Adawy Ahmad
- Ade-Ajayi Niyi
- Adegboyega Rilwan
- Ademuyiwa Adesoji
- Adesanya Opeoluwa
- Adhiwidjaja Cathline Freya
- Adofo-Ansong Nana
- Agboola Titiloye Hannah
- Agelebe Efeturi
- Aguilar Aguilar Faye
- Aguilar Gargurevich Prince Pamela
- Aguirre-Lopez Pastor
- Agulham Miguel Angelo
- Ahmad Hira
- Ahmad Zahidah Adlynee Haji
- Ahmed Hazem
- Ahmed Mahmoud Abdelfattah
- Ajai Olalekan Temitope
- Ajao Emmanuel Akinlabi
- Ajiboye Olalekan S.
- Ajrami Yara
- Ajwa Ahmad Elian Abu
- Akan M. Eren
- Akhbari Melika
- Akhter Nadeem
- Akova Fatih
- Al-Attar Hala M.
- Al-Halbouni Layana
- Al-Mamun Abdullah
- Al-Mayoof Ali Farooq
- Al-Momani Hashem M.
- Al-Mouakeh Ahmad
- Al-Rayyes Maisara
- Al-saleem Hasan Subhi Hasan Abu
- Al-Salhi Ashraf Ayman
- Al-Shwaikh Samar H.
- Al-Slaibi Ibrahim
- Al-Taher Raed Nael
- Al-Taher Raed Nael
- Al-Tammam Hiba
- Alakaloko Felix
- Alamrain Abdulwhhab Ayman Abu
- Alanguia Chipana Cathy Lee
- Alattas Khalid
- Alberto Carlos
- Albozidi Aya
- Alcántara Elvyn
- ALDIRAWI MOHAMMED A. M.
- Alebbini Mohanad Mutasem
- Alfoghi Mabroka
- Algabri Hayder Nadhim Obaid
- Alglaib Mohammed Meftah
- Alhamid Ahmad
- Alhamid Aos
- Alhassan Priscilla
- Ali Hassan
- Ali Karim Osamy
- Ali Liza
- Ali Mansour
- Alijla Sharif
- Alijla Sharif S.
- Aliwisat Ahmad Hasan
- Aljaboo Hajir
- Aljadidi Wesal Omar F. Saied
- Aljarad Ziad
- Alkareem Raghad mohammad abdu
- Almada Suad Ahmed
- Almadhoun Walaa
- Almasri Murad
- Almeida Aguiar Arthur
- Almeida Giovana
- Almengar Inas
- Almohamady Hisham
- Almosaibli Mohammad
- Almusleh Tasneem Fathi Hasan
- Alnaeri Ali
- Alnahhal Khaled
- Alonso Verónica
- Alosta Hasan Mustafa
- Alqarajeh Firas
- Alqor Mohammad Omar Ibrahim
- Alsaadi Nijmeh Nasser
- Alsaggaf Ameen
- Alsaied Amer
- Alser Mohammed
- Alser Osaid H.
- Alshaikhkhalil Haya Abdulnasser Ali
- Alshehri Abdullah
- Altaweel Ahmed
- Altın Merve
- Altokhais Tariq
- Altomi Mohamed
- Alturki Fahad
- Alvarado Zelada Jackelyne
- Alves Dutra da Silva Érika
- Alwadia Soha Marwan Salem
- Alwaggaa Nouriyah Ali
- Alzamari Ainaa Ata Mohammad
- Alzate Gallego Edgar
- Alzeer Asmahan Mohammad Suliman
- Alzerei Sulaiman T.
- Alzraikat Sayel H.
- Alzubair Afnan
- Alzughayyar Tareq Z.
- Amad Mohamed
- Amado Fernando
- Amaechi Chukwubinyelum
- Amah Christopher Chim
- Amarin Justin Z.
- Amarin Marzouq
- Ambriz-González Gabriela
- Ameh Emmanuel
- Amjad Muhammad Bin
- Amoabin Afua Amoabin
- Anatole Nzanzu
- Anatole Nzanzu Kipata
- Anaya Dominguez Marlene
- Anaya Firas
- Andrade Jerhy
- Andreussi Lorna
- Anicama Elias Rocio
- Annajjar Mohammad hasan
- Anntinea Jessmine
- Antunes Amanda
- Antunez-Mora Alexandra
- Anyomih Theophilus Teddy Kojo
- Anzelewicz Stefan
- Apaza Leon Jose Luis
- Appeadu-Mensah William
- Arabiat Esraa
- Arafa Mohamed Ahmed
- Arafat Hasan
- Aragão Liliana
- Arancibia Gutiérrez Elsa
- Aranda Sánchez Cristian Irela
- Arar Ahmad Samih
- Arauco Jenny
- Arbab Hana
- Arboleda Jenny
- Aremo Anuoluwapo
- Arnadóttir Helena
- Arnaud Alexis P
- Arnold Marion
- Arnoletto Lucia Beatriz
- Arrmali Saddam
- Arrmalli Lina Ali
- Arshad Muhammad
- Arthur Felicity
- Arul Suren
- Ashour Dina Ayman
- Ashour Yara shareef
- Aslan Yakup
- Aspirot Ann
- Assi Ahmadfateh
- Assi Muath Abdelrahem Fuad
- Astudillo Miguel
- Atatri Yazid yousef mahmoud
- Atta Ahmed
- Attia Alaa Mobarak
- Avile Romina
- Avolio Luigi
- Awad Hadeel
- Aydin Emrah
- Aykut Merve
- Ayque Rosas Fernando
- Aziz Dayang Anita Abdul
- Ba'baa' Basheer
- Badr Helmy
- Baertschiger Reto
- Bagbio Dominic
- Bah Abdoulie
- Bai Qiang
- Bai Yu Zuo
- Baistrocchi Valentina
- Bakar Ainal Huda Abu
- Baker Wisam
- Ballouhey Quentin
- Balousha Abrar ghassan
- Bamanga Ahmed
- Baniowda Muath A. M.
- Bao Xiaozhou
- Barauskas Vidmantas
- Barbosa Patricia Reis
- Baseggio Natalia
- Bashir Fatma
- Bashir Muhammad Kashif
- Bassan Gonçalves Paulo César
- Bataineh Ziad A.
- Batal Mohammad Mohannad
- Bazozi Hana Milad
- Beasley Spencer
- Becker Karin
- Belmino Gadelha Aluísio Augusto
- Benaskeur Yousra-Imane
- Beres Alana
- Berková Klára
- Bernaus Marianela
- Berrocal Anaya Waldo
- Berzanskis Mindaugas
- Beshtawi Doha mustafa saleh
- Beşir Ahmet
- Bianchin Ezequiel
- Bibas Fatma
- Biber Elna
- Bischoff Cristiano
- Bismarck Sylvester von
- Blain Otilia Eva
- Blanc Thomas
- Blazquez-Gomez Eva
- Bobadilla Morales Lucina
- Bode Christopher
- Bonnard Arnaud
- Boonthai Ampaipan
- Borbonet Daniel
- Bouhadiba Nordeen
- Bowder Alex
- Bracho Blanchet Eduardo
- Bradshaw Kate
- Bragagnini Paolo
- Brahmamdam Pavan
- Bravo Mauro Nicolas
- Bright Benedict Paul
- Brito Quevedo Luz Mery
- Broch Aline
- Brolin Santis Isolan Paola Maria
- Brunero Marco
- Bruxel Carla Luisa
- Bsisu Isam
- Bucaram Elena
- Bueno Mazzuca Rafael
- Bueno Motter Sarah
- Bujarimin Ahmad Shafiee bin
- Bulnes Mendizabal David
- Burks Stephen S.
- Burns Kate
- Butler Marilyn
- Bvulani Bruce
- C. Nwosu David
- Caamal Lorenzo Juvencio
- Calancea Calin
- Calderon Moore Antonio
- Calderón Arancibia José Alfredo
- Calistus Nwachukwu
- Cama Jitoko
- Camamra Kajali
- Cameron Fraser
- Camp Lauren
- Canözer Ali
- Caouette-Laberge Louise
- Cardenas Alva Loreley Raquel
- Cardenas Ruiz Velasco Juan Jose
- Carrasco Ana Lucia
- Carrasco-Ortega Cesar
- Carrillo Isabel
- Casado Francis Tanise
- Casal Beloy Isabel
- Caseb Paloma
- Casquero Victor
- Castañeda Espinosa Sergio
- Castaño Avila Daniela
- Castedo Camacho Fabiola Ruth
- Cavaiuolo Silvia
- Cañapataña Sahuanay Veronica Raquel
- Cepeda Rodrigo
- Cesur İlknur Banlı
- Chan Jonathan
- Chang Jeremy
- Charras Maria Delia
- Chaudary Ali Raza
- Chaudhry Muhammad Amjad
- Chauhan Nirav
- Chavez Galvez Patricia
- Chen Lulu
- Chen Rui
- Cheung Maija
- Chipalavela Rossana Francisco
- Chiriboga Elena
- Chitiavi Soita Wycliffe
- Chitnis Milind
- Cho Seok Hyeon
- Choo Candy SC
- Chukwu Isaac
- Chukwuemeka Anyanwu Lofty-John
- Chung Jae Hee
- Cletus Cyril
- Coghill Griffin
- Collins Nwokoro
- Colombo de Holanda Felipe
- Contreras Carla Sofia
- Coon John
- Cordonnier Annelien
- Cornelli Fabio
- Cornwall Hannah
- Corona C. Rivera Jorge Román
- Corona Rivera Alfredo
- Correa Leite Mila Torii
- Correa Armandou
- Correa Catalina
- Corrêa Costa Eduardo
- Cosoreanu Vlad
- Costas-Chavarri Ainhoa
- Cripovich Alejandrina
- Cunningham Aaron
- Czauderna Piotr
- Cáceres Aucatoma Freud
- Cárdenas Barón José de Jesús
- Cömert Hatice Sonay Yalçın
- da Silva Augusto Maria Lucia
- Dagilytė Rūta
- Dahman Nesrine Ben Hadj
- Dajia Wang
- Dalek Noor Fa'izatul Rahil Ambok
- Dallegre Maria Belen
- Dalloul Hisham
- Damiani Andrea
- Dammagh Nagham Mohammed Al
- Dania Bouguermouh
- Darras Osama Majed
- Darwish Ahmed S
- Darwish Ammar
- Dass Anthony
- Dassonville Martine
- Davenport Kate
- David Kuria
- Davies Justine
- Davis Jenna Kylene
- de Assis Silva Murilo
- de Azevedo Belesa Flavia
- de Campos Vieira Abib Simone
- de Deus Passos Leles Kamila
- de Guzman Johann
- de Souza Santos Ferreira Mariana
- Dedeke Florence
- Defago Victor Hugo
- Defert Coralie
- Delefortrie Thomas
- Delforge Xavier
- Delft Dirk von
- Delgado Malaga Florangel Patricia
- Delgado Quinteros Edgar Fernando
- Dellenmark Blom Michaela
- Dendusic Nejra
- Derbew Miliard
- Derks Terry
- Deya Corazone
- Deyab Abdelaziz
- Di Siervi Oscar
- Diaz Castañeda Flor de Maria
- Diaz Echegaray Marlene
- Diaz Gomez Jose Manuel
- Diaz Leon Cesar
- Dieudonné Lemfuka
- Dimatatac Doris Mae
- Djordjevic Ivona
- Dogar Sohail
- Doheim Mohamed Fahmy
- Dominguez Danny
- Donglai Hu
- Dornellas do Nascimento Suely
- dos Santos Dias André Iván Bradley
- Dosselman Luke J.
- Douiri Abdel
- Drah Weam
- Dube Andile Maqhawe
- Duchesne Camille
- Duggan Eileen
- Duote Cai
- Dure Carolina
- Dávila Perez Roberto
- Ebeido Annan
- Egbuchulem Ifeanyichukwu Kelvin
- Ejinkeonye Eze Chukwuemeka
- Ekenze Sebastian Okwuchukwu
- Ekwunife Okechukwu Hyginus
- El-Ghazaly Mohammed
- Elassall Gena Mohamed Hamed
- Elayeb Abdallah
- Elebute Olumide Abiodun
- Elewaily Mohamed
- Elfiky Mahmoud
- Elgammudi Mala
- Elghazaly Shrouk Mahmoud
- Elhadi Ahmed
- Elhadi Muhammed
- Elhajjaji Yasmine Ali
- Elhattab Ahmad
- Elisante Joseph
- Elkaloush Abdullahn Abdousalam
- Elkhazmi Ebtesam Othman Abdulsalam
- Elmenam Mohamed Abd
- Elmzyyen Aya Mahmoud
- Elrais Safa Abdal
- Elsadek Menan Ahmed
- Elsaied Adham
- Elshaer Omar Adly
- Elsherbiny Mohamed
- Elsiraffy Omar Ossama
- Elstad Maria
- Elzohiri Mohamed
- Elzowawi Fathi
- Emam Omar Sameh
- Emil Sherif
- Enbaya Manal Ben
- Ensar Nicholas
- Erdem Melisa
- Eren Elif
- Ergenekon Ebru
- Eroğlu Egemen
- Erturk Nazile
- Erçin Seçil
- Eshkabilov Shukurali
- Espineda Beda
- Essa Tarek Mohamed
- Essamilghi Kamila Almabrouk Mohammed
- Ezidiegwu Ugochukwu S
- Ezomike Uchechukwu Obiora
- Faboya Omolara Moronkeji
- Fachin Camila
- Fadhle Muhamed Jassim
- Faks Vivian
- Falah Eyad Hassan
- Farag Eman mohamed
- Fares Jehad
- Farha Mervat Sufian Abu
- Farion-Aguiar Luiz
- Fawzy Omar Moustafa
- Fayez Mohamed
- Fazli Mohamad Rafi
- Feldens Leticia
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- Ferdousi Tamanna
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- Fernandes de Souza Rachel
- Fernandez Ferrer Marianelly
- Fernandez Portilla Emilio
- Fernandez Wilson Miriam Daniela
- Ferraz Schopf Luciano
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- Ford Kat
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- Fouda Mohamed Fayez
- Fouly Mariam Albatoul Nageh
- Fouquet-Languillat Virginie
- Fourcade Laurent
- Fowler Kathryn L
- Fox Sarah
- Franco Helena
- Furtado Meyer Karine
- Furtado Mariana
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- Gall Caroline Le
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- Gao Zhigang
- Gao Zhou Chong
- Garcia Martinez Humberto
- Garcia Isidora
- Garcia Virginia
- Garcia-Aparicio Luis
- García Miriam
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- Garnier Hanna
- Garrett-Cox Robin
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- Gatzinsky Vladimir
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- Gavrilovska-Brzanov Aleksandra
- Gee Oliver
- Gerus Sylwester
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- Ghallab Alaa
- Ghaly Khaled Abd elrahman
- Ghanem Waleed H.
- Ghayth Sumayyah
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- Ghilardi Silva Ximena
- Ghorab Islam Abdelmonem
- Ghosh Dhruv
- Gilardi Jose
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- Goddard Lucy
- Goebel Peter
- Gohil Hetal
- Gomes Adriano Luis
- Gomez Juanita
- Gomez Oscar
- Gondal Mudassir Fayaz
- Gonzales Brandy
- Gonzalez Cortez Luis Fernando
- Gonzalez Daniel Emilio
- Gonzalez Joann
- González Ojeda Alejandro
- Gonçalves Borges Carolina
- Gonçalves da Cunha
- Gonçalves Victor
- Gosain Ankush
- Grabowski Andrzej
- Granéli Christina
- Greenberg Jodie
- Grella Maria Giovanna
- Grosos Céline
- Grottling Emma
- Grynberg Lucie
- Guadagno Elena
- Guayelema Marisol
- Guazzotti Marinella
- Guerin Florent
- Guimarães Patricia
- Guinsburg Ruth
- Guisse Carmen
- Gurgel do Amaral Antonio Cipriano
- Gurskas Pranas
- Gutarra Palomino Andrea
- Gutierrez Maldonado Joan Elizabeth
- Habiba Alouani
- Hagander Lars
- Hagander Lars
- Haidari Sayed Aman
- Haider Naveed
- Hajajreh Ma'alem sameer
- Hakan Nilay
- Halabi Yasmeen Adly
- Hall Nigel
- Hall Timothy
- Hameed Soban
- Hamidi Nadia
- Hamidovic Ajla
- Hamill James
- Hamilton April
- Hammato Abdalkarim Yhya
- Hammond Philip
- Hammouri Ahmad G.
- Hamzah Siti Nur Aien binti Hamid
- Han Yijiang
- Hanifah Nur Atiqah binti Mohd
- Haraux Elodie
- Harilal Shamaman
- Harper Luke
- Hasan Samiul
- Hasan Samiul
- Hasanain Doaa Khalil
- Hashim Hidayah Hayati binti
- Hashim Imran
- Hashim Sophia
- Hassan Majd Yousef Mohammed
- Hassan Mohamed Abada
- Hassan Mohd Razin bin
- Hassan Zulfitri bin Md
- Herappe Mellado Dorihela
- Herdan Mohamed Omar
- Hernández Córdova Karina
- Herrera Pesara Luciana Martina
- Herrera Carina
- Herrera Laura
- Hery Géraldine
- Hinostroza Daniel
- Hisham Intisar
- Hodgman Erica
- Honhar Medhavi
- Horacio Bonavia
- Horozic Dzan
- Hospital Sonia Inamuco
- Huang Liuming
- Huang Shungen
- Huang Ting
- Huaytalla Quiroz Natalia
- Huespe Enrique
- Hukic Lamija
- Huq Umama
- Hussain Syeda Ra'ana
- Hussein Omar Ghazi
- Hussein Sara Al
- Hussien Muaad
- Hwang In ji
- Hyeon Cho Seok
- Hyman Gabriella
- Ibarra Daniel
- Ibrahim Eman Abouzeid Abouzeid
- Ibrahim Fowzia
- Ibrahim Mahmoud abdelshakour
- Ibukunolu Ogundele
- Igoche Matthias
- Ihediwa George
- İmamoğlu Mustafa
- Ionescu Sebastian
- Iracelay Susana
- Iriondo Martí
- Ishak Shareena
- Ismail Enas Musa
- Ismavel Vijay Anand
- Itangishaka Innocent
- Ivanov Monica
- Jabaiti Mohammad S.
- Jabang John N.
- Jaber Dania
- Jacobson Jillian
- Jain Sunil
- Jaiteh Musa
- Jallow Cherno S.
- Jalo Iliya
- Jamal Muhammad Umer
- Jamie Najlaa Abu
- Jamie Yasmin Mohammed Khalil Abu
- Jaramillo Martha
- Jauri Cesar
- Jayaratnam Sridharan
- Jayyab Mustafa abu
- Jester Ingo
- Jimenez Morejon Vinicio
- Joda Ali Egab
- Joharifard Shahrzad
- Johnson Stephanie
- Jones Brendan
- Jones Ceri
- Jones Matthew
- Jonuzi Asmir
- Jooma Uzair
- Joubeh Sharehan
- Jovcheski Laze
- Jr Acimar
- Juhasz Laszlo
- Julio Lapalma
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- Junjie Chen
- Junyi Wang
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- Karakus Suleyman Cuneyt
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- Karavdic Kenan
- Karim Sabbir
- Karim Safina
- Kaya Hatice
- Kayed Yara Imad Omar
- Kayibanda Emmanuel
- Kchiche Nahla
- Kelay Arun
- Keleş Elif
- Keshtgar Alireza
- Khaled Ala
- Khalel Wegden ibrahim almabrouk
- Khalid Hazlina Mohd.
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- Khatatba Lara Zahi Adel
- Khattak Muhammad Adnan Khan
- Khlevner Julie
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- Kukkady Askar
- Kumar Vijay
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- Lawalbarau Abdullahi
- Layas Tesneem
- Laymouna Moustafa A.
- Leal Paola Osses
- Leather Andrew J. M.
- Lechmiannandan Abhirrami
- Ledesma Peraza Jesmarina
- Lee Ju yeon
- Lee Sanghoon
- Leech Mary
- Lerma Sergio
- Letic Emina
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- Levitt Marc
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- León Frutos Francisco Javier
- Li Haijing
- Li Shungen
- Li Zhongrong
- Liang Liang
- Liljesthrom Karen
- Lim Felicia
- Lin Nicole
- Lindert Judith
- Lino Urquizo Marcelo Mauricio
- Liu Yang
- Liubsys Arunas
- Liukitithara Sirima
- Ljuhar Damir
- Llap Unchón Genaro
- Lobos Pablo
- Lodhia Jay
- Loo Neyra Maria Susana
- Lopes de Almeida Thayná
- Lopes Teixeira Ferdinando Danielle
- Losa Gabriela Natalia
- Losty Paul
- Lotfollahzadeh Saran
- Loyola Ferreira Julia
- Lu Jinjing
- Lubbad Walaa
- Lucio Palazzi
- Lui Yang
- Lukac Marija
- Lule Joseph
- Luo Wenjuan
- Lv Junying
- Lv Zhibao
- Lyttle Bailey D.
- Løfberg Katrine
- M. Ballah Abubakar
- M. Qabaja Mahmoud
- Mac Carlos
- Macdonald Alex
- Machemedze Solomon
- Madieh Jomana
- Madziba Sanele
- Mahmoud Ahmed Mokhtar
- Mahmud Khalid
- Mahmud Refoyez
- Mairami Amsa B.
- Maistry Niveshni
- Makhmud Aliev
- Malcius Dalius
- Malik Janan
- Malik Sawazen
- Mancera Juliana
- Mangray Hansraj
- Manirambona Emery
- Manjira Emmanuel
- Manni Francesco
- Mansfield Sara
- Mansour Islam
- Mansour Mohamed Awad
- Marcos Dolores
- Marianella Depetrini
- Marmol Monica
- Marta Osowicka
- Martin Aranda Diego
- Martin Benjamin
- Martinez-Leo Bruno
- Martins Bianca M. R.
- Martínez Hernández Magro Nestor
- Mary Koshy Roshine
- Massry Nasrallah Ashraf Al
- Matour Bashar M.
- Mayaleh Abdelrazzaq Abu
- Mbonicura Jean Claude
- Mbonisweni Akhona
- Mccluney Simon
- McColl Makepeace Lydia
- Medard Pablo
- Meftah Asma
- Melo Gallindo Rodrigo
- Meloche-Dumas Léamarie
- Mena Adriana
- Mendez Benavente Carolina
- Mendoza Chiroque Carlos
- Mendoza Leon Nancy Rossana
- Mendoza Oviedo Juan Jose
- Menin Flavio Augusto
- Mercado Pedro
- Mert Mustafa Kurthan
- Merwe Elmarie vd
- Mesas Burgos Carmen
- Mesic Amira
- Michael Vishal
- Middlesworth William
- Middleton Thomas
- Mieres Carlos
- Mikneviciute Agne
- Milisic Emir
- Millán Carolina
- Miriam Ann
- Mironescu Aurel
- Mirza Muhammad Bilal
- Misk Rami Anwar
- Mitul Ashrarur
- Mitul Ashrarur Rahman
- Modekwe Victor
- Modi Varun
- Mohammad Mohammad Aminu
- Mohammed Abobaker
- Mohammed Azhar Arabi
- Mohammed Hanan Mahmoud
- Mohammed Mansour Mkayed
- Mohammed Ola Ahmed Abdulmjeed
- Moitt Natalie
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- Saad Mahmoud M.
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- Saleem Ayesha
- Saleem Muhammad
- Saleh Amr
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- Salinas Vicente
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- Samarah Yasmeen Ahmad
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- Sidler Daniel
- Sigalet David
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- Suradi Haya H.
- Sutcliffe Jonathan
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- Türkyılmaz Canan
- Türkyılmaz Zafer
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- Ugwu Jideofor O
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- Vacek Jonathan
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- Vanis Nedim
- Vaquila Justo
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- Vasquez Matos Juan Pedro
- Vatta Fabrizio
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- Vellusamy V Muthualhagi M
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- Vianney Butoyi Jean Marie
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- Vidal Cristian R. Zalles
- Vierboom Liam
- Villalba Villalba Araceli
- Villegas Silva Raúl
- Vinskaite Asta
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- Vosoughi Armin
- Wafa Tamer
- Walker Gregor
- Wang Jinhu
- Wang Peng
- Waseem Basma
- Weeratunga Naveen
- Weiszewsk Alicja
- Wen Gang
- Werneck Raposo Juliana
- Wester Tomas
- Wijekoon Naveen
- Wilke Alexandra
- Williams Isabelle
- Williams Omolara
- Williams Regan
- Win Win Sabai Phyu
- Wishah Bisan D. M.
- Wishah Nidal
- Wissanji Hussein
- Wolak Przemyslaw
- Wolny Agnieszka
- Wong Janice
- Wong Marilyn
- Wright Naomi Jane
- Wu Guowei
- Wyrzykowski Dariusz
- Xiaodong Guo
- Xie Hua
- Yacoub Mina A.
- Yaghi Bashar
- Yaghi Dua Hasan
- Yalcinkaya Ali
- Yang Hee-Beom
- Yanis Ahmad H.
- Yanowsky Reyes Guillermo
- Yao Yang
- Yapo Benjamin
- Yarza Fernández Jessica
- Yeniay Aslı Öztürk
- Yola Mariya Mukhtar
- Yong Feng
- Youn Joong Kee
- Yousuf Hina
- Yu Mengnan
- Yu Raisa
- Yuen Quah Soong
- Yuldashev Rustam Z.
- Yunus Aayenah
- Za'nouneh Faris J. Abu
- Zaghlol Louay Y.
- Zahari Dato' Dr Zakaria bin
- Zain Mostafa
- Zaman Azrina SK
- Zanellato Josiane Bernartt
- Zarwawi Ahmad Zulhisyam bin
- Zea-Salazar Luis Enrique
- Zeinelabdeen Ali
- Zhao Xiaoxia
- Zhu Jianming
- Zhu Libin
- Zidan Mazen
- Zivanovic Dragoljub
- Zottis Barcelos Fabricio
- Zreeg Dafer abdulhakim . S.
- Zurikat Rajai O.
- Zvizdic Nada
- Zvizdic Zlatan
- Çekiç Bahanur
- Çelik Müge
- Özçelik Zerrin
- Şeref Kıvanç
- Šafus Antonín
- Škvařil Jan
- Štichhauer Radek
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies
- Author
- Aage Christiansen
- Aaradhana Adhikari
- Aaron Venti
- Aayesha Qadeer
- Abdellatif Benslama
- Abigail Beane
- Abu Hena Mostafa Kamal
- Abul Faiz
- Adam B Schlichting
- Adam Bell Bell
- Adenilton M R Ampinelli
- Aditya Uppalapati
- Adrian Donnelly
- Adriana M Fernandez
- Adrien Robine
- Aftab Akhtar
- Agreta Gecaj-Gashi
- Ahmed Farooq
- Ahmed S Al Jabbary
- Ahmet Dilek
- Ahmet Sukru Denker
- Ai Y Hang
- Aiman Tulaimat
- Akihiro Takaba
- Akinori Uchiyama
- Akira Hirata
- Akm Shamsul Alam
- Akut Aytulun
- Alain Combes
- Alain M Dive
- Alain Mercat
- Alain U Alisasis
- Alan Zazu
- Alastair Rose
- Alberto Deicas
- Alec A Tallet Alfonso
- Alejandro A Saez
- Alejandro Ebeid
- Alejandro G Castro
- Alejandro R Bruhn
- Alek Kumar
- Alessandro Bacuzzi
- Alessandro Protti
- Alessia Mattei
- Alex Mcleod
- Alex Morton
- Alexandra Ceniceros-Barros
- Alexandra J Williams
- Alexandra Marcu
- Alexandra Siqueira Colombo
- Alexandre Biasi Cavalcanti
- Alexandre Biasi Cavalcanti
- Alexandre Chan
- Alexandre Demoule
- Alexandre Guilherme Ribeiro de Carvalho
- Alexandre Molin
- Alexandre Molin
- Alexey I Gritsan
- Alfons Arizmendi
- Aline Ascoli
- Alison Ghosh
- Alistair Nichol
- Alistair Roy Roy
- Alma Cani
- Alvaro Ramirez-Gutierrez
- Amadeu Martinez
- Amanda Cowton
- Amanda Krstevski
- Amanda Maria R R de Oliveira
- Amanda Skinner
- Amanda Whileman
- Amine Ali Zeggwagh
- Amine Ali Zeggwagh
- Amy McInerney
- Ana Carolina P Antônio
- Ana Carolina Peçanha
- Ana G França
- Ana M Araujo
- Ana M Pellicer
- Anais Briquet
- Anand Dongre
- Anatole Harrois
- Anders Aneman
- Anders Larsson
- Andre Japiassu
- Andre Luiz Baptiston Nunes
- Andre Luiz Baptiston Nunes
- Andre Vercueil
- Andrea Coppadoro
- Andrea Cortegiani
- Andrea Cortegiani
- Andrea Lombardo
- Andrea N Cracchiolo
- Andrea Tinnirello
- Andreas Barratt-Due
- Andreas W Reske
- Andrej Sribar
- Andrew Bentley
- Andrew Corner
- Andrew Ferguson
- Andrew J Burtenshaw
- Andrey A Gazenkampf
- André Peretti Torelly
- Angela Delsing
- Angela Pinder
- Aniko D Frigyik
- Anil Hormis
- Anil P Hormis
- Anitha Shenoy
- Anna Hunt
- Anna Oscarsson Tibblin
- Anna Rossi
- Anna T Dowling
- Anna Walker
- Anna-Karin Morin
- Anne Adolfsson
- Anne B Guttormsen
- Annop Piriyapatsom
- Antero do Vale Fernandes
- Antoine Pronovost
- Antonino Giarratano
- Antonio Artigas
- Antonio Braschi
- Antonio Carlos Nogueira
- Antonio G Jimenez
- Antonio Jorge Pereira
- Antonio L Ruiz-Aguilar
- Antonio P Nassar Jr
- Antonio Paulo Nassar Junior
- António M Alvarez
- António M Messias
- Aogan C O'Muircheartaigh
- Areef Ahsan
- Areej Javeed
- Ariel Chena
- Arnaud Follin
- Arshad Taqi
- Arvind K Baronia
- Ary Serpa Neto
- Ashley Schomer
- Ashok S Raj
- Asisclo J Villagomez
- Asisclo Villagomez
- Asma Ben Souissi
- Asma Navasakulpong
- Asoka Gunaratne
- Atta Ur Rehman
- Aurelia M Martinho
- Aylin Seven
- Bao H Zhu
- Barbara Brunettini
- Barbara do Cs Martins
- Barrett T Kitch
- Barry Dixon
- Barry Kennedy
- Basak Ceyda Meco
- Batoul Khoundabi
- Beatriz C Tan
- Behzad Nadjm
- Ben Creagh-Brown
- Bernard Goubaux
- Bernhard Holzgraefe
- Bhagyesh Shah
- Bhuvana Krishna
- Bimal Kudavidanage
- Bin Li
- Bingyu Qin
- Bojan Jovanovic
- Boris G Villamagua
- Brenno Cardoso Gomes
- Brigit L Roberts
- Brit Å Sjøbø
- Bruno Franco Mazza
- Bruno Gelée
- Bruno S Oliveira
- Candelaria De Haro
- Carlo A Volta
- Carlo Alberto Volta
- Carlos A Pellegrini
- Carlos Eduardo Barboza
- Carlos Munhoz
- Carlos S Pereira
- Carly Brown
- Carmen Scott
- Carolina Quintana Grijalba
- Carolina S Insaurralde
- Carolina Serra
- Caroline Berghe
- Caroline C MacFie
- Caroline Wreybrown
- Cassia Righy
- Cassiano Teixeira
- Catalina Forteza
- Catherine Plowright
- Cecilia Carbayo-Gorriz
- Cecilia Hermosa
- Ceri E Battle
- Cesar A Cortez
- Cesar Milstein
- Cesar P Pere
- Chamila Pilimatalawwe
- Charlene Bigot
- Charlene Le Moal
- Charlotte Downes
- Chathurani Sigera
- Chern Min Voon
- Cheryl Padilla-Harris
- Chinni Krishna Kasi
- Chloe Hughes
- Christian C Rylander
- Christian Dellera
- Christian Frey
- Christian M Ramirez-Alfaro
- Christian Schlegel
- Christina Whitehead
- Christine Boyd
- Christine Brown
- Christine Ryan
- Christoph Muench
- Christopher J Scott
- Christopher Nutt
- Christopher Smalley
- Christopher Tainter
- Chunting Wang
- Claine Judy
- Clair Harris
- Claire Kaloo
- Claire Matthews
- Claire Miller
- Claire Pegg
- Claire Reynolds
- Clare Bullock
- Clare Mellis
- Clare Mellis
- Claude Guérin
- Claudia A Ortiz
- Claudia R Estrella
- Claudio H Gonçalves
- Claudio Piras
- Claudio Piras
- Claudio Piras
- Colette Seasman
- Colette Seasman
- Colin K Grissom
- Colin Mcarthur
- Colin S Black
- Cora Lavigne Moreira
- Corcoles G Virgilio
- Corinne Leemann-Refondini
- Cristiane Ritter
- Cristiane Tomasi Damiani
- Cristina M Cox
- Cristina Prata Amendola
- Cristina Santos
- Cristina Santos
- Cédric Daubin
- Daisuke Niimi
- Dale J Yeatts
- Dalton de Souza Barros
- Damien Roux
- Dan E Corneci
- Dan Hadfield
- Dana R Tomescu
- Daniel Aragão
- Daniel Beraldo
- Daniel Collins
- Daniel da Cunha Ribeiro
- Daniel F McAuley
- Daniel Hadfield
- Daniel Hull
- Daniel O Beraldo
- Daniel Prado
- Daniel R Crouch
- Daniel R Gonzalez
- Daniel V Collins
- Daniela Albiero
- Daniela M Palma
- Daniela N Vasquez
- Daniele M Combaux
- Danielle A Fawkes
- Danielle C Fontenele
- Danielle J Hacking
- Danielle Nobrega
- Danielle Reuter
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- Tomaz Mesar
- Tommaso Fossali
- Tomoaki Hashida
- Tomofumi Harasawa
- Tomoyuki Nakamura
- Toni E Mckenna
- Toshikazu Abe
- Tracey Evans
- Trevor W Oetting
- Troy S B Rowne
- Tài Pham
- Udomsak Silachamroon
- Ugur Goktas
- Ulysses V A Silva
- Una Poultney
- Unase Buyukkocak
- Upeka Samaranayake
- Ushio Higashijima
- Valeria I Cerrato
- Valerie M Banner-Goodspeed
- Vallish K Bhardwaj
- Vallverdu P Imma
- Valéria Maria Campos Rezende
- Vanessa Linnett
- Vanessa M Sales
- Vanessa Oliveira
- Vania A Brito
- Varsha Kadaba
- Vasilis Ourailogloy
- Venika Manoharan
- Venkatapura J Ramesh
- Veronica Villar
- Vesna Bumbasierevic
- Vesna Bumbasirevic
- Vicente Cés de Souza Dantas
- Vijayanand Palaniswamy
- Vincenzo Pota
- Vincenzo Russotto
- Vincenzo Schiavone
- Viratch Tangsujaritvijit
- Virginie Lemiale
- Visanthi Pinto
- Vivek Kakar
- Vladimir Cerny
- Vlasta Klaric
- Wahid Altaf
- Wajdi Maazouzi
- Wei H Zhu
- Wei Wang
- Weihua Lu
- Wenkui Yu
- Wenwen Li
- Werner Schmid
- William Stigler
- Xavier Wittebole
- Xian Y Zhao
- Xiao B Huang
- Xiao L Li
- Xiaoming Luo
- Xing Y Zhang
- Xinyu Li
- Y A Hasitha Dilhani
- Ya Q Wu
- Yaasen Arabi
- Yan Gao
- Yaseen M Arabi
- Yasuaki Ogino
- Yavuz Orak
- Yen Lam Minh
- Yi Han
- Yimin Li
- Yonghao Xu
- Yoshihiro Yamaji
- Yoshinobu Kameyama
- Youssef Haddad
- Youzhong An
- Yozo Kashiwa
- Yu D Di
- Yuan N Gao
- Yuan Y Li
- Yuanhua Lu
- Yves D Jarquin-Badiola
- Zerrin Demirtürk
- Zhe Zhai
- Zheng L Ye
- Zhenyang He
- Zhou Li-Xin
- Álvaro Réa-Neto
- Ángela Algaba
- Ángela González-Salamanca
- Çiler Zincircioglu
- Érica Aranha Suzumura
- Ênio Rego
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies.
Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality.
Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001).
Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status
Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries
- Author
- A Yacoub Mina
- A. Adam Mohammed
- A. Nassar Mahmoud
- A.Nemer Ayoob
- Aahlin Eirik Kjus
- Ab Rahim Mohd Fadliyazid
- Abad Gurumeta Alfredo
- Abad-Motos Ane
- Abang Jamari Dyg Zahratul Hamrak
- Abantanga Francis
- Abarca Sol
- Abazid Eias
- Abbas Abbas
- Abbas Khalid
- Abbas Mohammad Monir
- Abbasy Jibran
- Abbosh Ali
- Abd Karim Muhammad Fairuz Shah
- Abd Wahab Haidar Hadri
- Abd Barook
- Abdalei Abdulwahab
- Abdalla Ahmed Elkamel Ahmed
- Abdallah Aya
- AbdAllah Mostafa Salim Mohamed
- Abdel Malik Abu Baker
- Abdelhady Mousa Heba
- Abdelhady Samar
- Abdelhakim Ahmed
- Abdelkader Muhammad
- Abdelkawy Shaza
- Abdelkhalek Mohamed
- Abdellatif Esraa
- Abdelmaksoud Tawakel Noura
- Abdelmohsen Naglaa
- Abdelmotaleb Ibrahem
- Abdelrazek Aly
- Abdelsalam Israa
- Abdelshakour Mahmoud
- Abdelwahed Ahmed Mohamed
- Abdou Abdulrahman Osama
- Abdou Alrawy
- Abdou Hossam
- Abdul Aziz Mohamed Rezal
- Abdul Aziz Nora
- Abdulgawad Almogy Mariam
- Abdulla Mazin A.
- Abdullah Muhammad Tariq
- Abdullahi Lawal
- Abdullayev Seymur
- Abed Saeed
- Abelló David
- Abiola Olajide
- Abo mahadi Asmaa'
- Abo-khammash Areej
- Abou Chaar Mohamad K.
- Abou El.soud Moustafa Ramadan
- Abouelsoad Nervana
- Abraham Joyner
- Abreu da Silva Alberto
- Abu Ahammala Ayman B.
- Abu Al Amrain Mahmoud
- Abu Al-saleem Hasan
- Abu Alamrain Abdulwhhab
- Abu Alqumboz Amjad
- Abu Ataya Ahmed
- Abu hallalah Muad fathi khalleefah
- Abu Jamie Najlaa
- Abu Jayyab Israa
- Abu shua'ib Rana
- Abu Zainah Baraa
- Abu-Nimeh Samar
- Abu-Rous Mohammed R.
- Abu-srour Abrar
- Abuelhatal Hasan
- Abuelqomboz Ayham
- Abuhilal Baseel
- Abuhlaiga Ma'aly
- Abujamra Saleh
- Abukhalaf Sadi A.
- Abusalem Lana
- AbuSirrees Mahmoud
- Acevedo Veronica
- Acharya Rajgopal
- Achkasov Sergey
- Acosta Eric
- Adamo Karin
- Adamou Harissou
- Adams Jamie
- Adams Lawrence
- Adawi Samer
- Adebanjo Ademola
- Adel Marina
- Adel Sawsan
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji
- Adenuga Adedire
- Aderounmu Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adesunkanmi Abdul-Rashid
- Adeyeye Ademola
- Adidharma Peter
- Adisa Adewale O
- Adnan Nour
- Afifi Amr Abdelghani
- Afifi Eman
- Afolayan Michael Olatunji
- Afzal Asma
- Agarwal Arnav
- Agarwal Raksheeth
- Agbakwuru Augustine
- Agbeko Anita Eseenam
- Aguilar Martinez Maria Del Mar
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlqvist Sandra
- Ahmad Izzuddin Ahmad Imran
- Ahmad Kasim
- Ahmad Sarwat
- Ahmed Ahmedgaber
- Ahmed Hazem Abdelkarem
- Ahmed Mariam
- Ahmed Nabila
- Ahmed Zahra
- Ainoa Eppu
- Aithie Joanna M S
- Ajani Costanza
- Ajao Akinlabi
- Ajiboye Anthony
- Ajmera Ankit
- Akande Oluwatosin
- Akaydin Elif
- Akbaba Ata Cem
- Akbar Sana Amir
- Akeel Nouf
- Akeem Aderogba Adeleke
- Akin Alp
- Akinkuolie Akinbolaji
- Akisheva Aygulya
- Akitikori Mabel Temisanren
- Akrida Ioanna
- Aktas Melik Kagan
- Al basos Iyad
- Al Farsi Maryam
- Al Nassrallah Majdi
- Al Sagheir Eman
- Al Saqqa Sara
- Al Saqqa Sara
- Al-Allaf Omar
- Al-Busaidi Ibrahim S.
- Al-Dhufri Ali
- Al-Himyari Hamza S.
- Al-Masri Mahmoud
- Al-Najjar Hani
- Al-Sabbagh Yusra
- Al-Shwaikh Samar
- Al-Slaibi Ibrahim
- Al-Taher Raed
- Al-Tammam Hiba
- Alabuzidi Aya
- Alagha Othman
- Alammarin Mohammad
- Alapatt John
- Alasttal Mohammed
- Alatise Olusegun Isaac
- Albaggar Marwa
- Albahnasawi Moath A.
- Albati Naif
- Alberga Anna
- Alberts Justin
- AlBsoul Ahmad
- Albsoul Nader
- Alcorta Rodrigo
- Alejandre Villalobos Cristina
- Alemdag Gökçe nur
- Alexander Philip
- Alfarra Nada
- Alfitory Asma
- Alhabil Belal
- Alhaj Ahmad
- Alherz Mohammad
- Alhimyar Maryam
- Ali Ahmad Syed Mustafa
- Ali SANI Samuel
- Ali Amr
- Ali Asmaa
- Ali Mahmoud
- Ali Shabina
- Alimi Marjan
- Aliosin Oleg
- Aliyu Halima
- Aljaafreh Almoutuz
- Aljaber Dana
- Aljaberi Loay
- Aljanfi Asma
- Aljiffry Murad
- Aljohmani Lylas
- Alkhaledi Ahmad
- Alkhatib Ala'a Aldeen
- Alkhatib Haya
- Alkhatib Mo'min
- Allen Ingabire J.C.
- Almasri Murad
- Almeida Braga Sara
- Almeida Filipe
- Almigheerbi Alabas
- Almoqayyad Abdelrahman
- Almuzghi Fakhruddin
- Alnoury Mostafa
- Alonso Batanero Ester
- Alqadi Mohammad
- Alsaid Bayan
- Alsalameh Barah
- Alsallaq Osama
- Alser Osaid
- Alshaar Muhammad
- Alsharef Tagwa
- Alsharqawi Nourah
- Alswerki Mohammad
- Altaf Amna
- Altaf Rabiya
- AlTaweel Mohammed
- Althini Abdulmunem Ahmed Mustafa
- Altibi Ahmed M.
- Altinel Yuksel
- Altiner Saygin
- Altomare Donato Francesco
- Altumei Zohoor
- Alvarez Rivera Alvaro Eduardo
- Alvarez-Cano Alethia
- Alves do Canto Brum Homero
- Alves Daniela Macedo
- Alves Magda
- Alvi Abdul
- Alwaheidi Malak
- Alwali Abdallah
- Alwerfally AbdulMawlay
- Alwhaidi Noor
- Alyafi Amr
- Alzabti Fatima
- Alzahaf Ahmed
- AlZohour Mohammad
- Amadou Magagi Ibrahim
- Amandito Radhian
- Amarin Justin Z.
- Amaro Margarida
- Ambrazevicius Marijus
- Amendola Alfonso
- Amin Leila
- Amine Souadka
- Amjad Talal
- Amorim Edgar
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- Anandan Premkumar
- Anas khalifa Rawda
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- Andersson Yvette
- Andreotti Dario
- Andrew David
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- Anggita Gultom Phebe
- Annapureddy Naga
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- Ansaloni Luca
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- Antaky Marco
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- Anthoulakis Christos
- Antonopoulou Maria Ioanna
- Anwar Mohamed
- Anwer Abdul Wahid
- Anyanwu Chikamuche
- Anyanwu Lofty-John
- Anyanwu Mercy Chinemerem
- Anyomih Theophilus Teddy Kojo
- Appukuttan Akhila
- Aquilino Fabrizio
- Archibald Jess
- Arciénega Yañez María del pilar
- Argentou Maria-Ioanna
- Argudo Nuria
- Argyriou Eleftherios Orestis
- Arias Madrid Natalia
- Aribi Sarra
- Arifin Ghafur Rasyid
- Arizpe Daniel
- Arnaud Alexis P
- Arora Bharti
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- Arowolo Olukayode
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- Asti Emanuele Luigi Giuseppe
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- Atallah Khalid
- Atanasov Boyko
- Atawneh Mohammad
- Athamneh Sarah
- Ather Muaaz
- Athisayaraj Thomas
- Atkociunas Aivaras
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- Au Angela
- Awad Israa
- Awadallah Haneen
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- Awesat Eman
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- Ayandipo Omobolaji
- Ayash Mohammad
- Ayau Fernanda
- Ayesh Kholoud
- Ayman El-sawy Esraa
- Ayoub Rami
- Aytac Erman
- Ayub Bushra
- Ayub Saima
- Ayyad Rawan
- Azevedo José
- Azodo Ijeoma
- Azzubia Joma
- B L Ashika
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- Babaa Basheer
- Babirye Lilian
- Bacic Ivan
- Badr Esraa Tarek
- Badr Helmy
- Badran Abdul
- Badwe Rajendra
- Bafford Andrea Chao M.D.
- Baggaley Caitlin
- Bahroun Sumayyah Ghayth
- Baiao José Miguel
- Baiocchi Daniella
- Bairos Menezes Maria
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- Bake Jacques
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- Balata Mohamed
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- Ballouhey Quentin
- Balogun Olanrewaju
- Baloyiannis Ioannis
- Baltaci Ege
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- Banglani Muntaha
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- Banks Alexander
- Bannister Sharon
- Baranyai Zsolt
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- Barbosa Camacho Francisco José
- Barbosa José
- Bardos David
- Barendegere Venerand
- Barghuthi Lutfi
- Barhoush Ola
- Barnes Nicole
- Baronio Gianluca
- Barreda Zelaya Lilian Elizabeth
- Barrera López Francisco Javier
- Barsic Neven
- Barter Charlotte
- Bartosiak Katarzyna
- Basarab Maksym
- Basso Stefano Maria Massimiliano.
- Bastiaenen Vivian
- Batashki Ilia
- Bath Michael
- Beattie Miriam
- Bedada Alemayehu Ginbo
- Belais Fanny
- Belal qadomi Asef
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- Beltrán de Heredia Juan
- Belvedere Angela
- Ben Dallah Najah
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- Bianchini Stefania
- Bianco Francesco
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- Biccard Bruce M
- Bielosludtsev Oleksii
- Bienfait Mumbere
- Billy Matthew
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- Binetti Margherita
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- Dominguez Joaquina
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- Drake Thomas M
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- Ekpete Ogbonnia
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- El Gharmoul Tasnim
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- El Nakeeb Ayman
- El sheikh Enas
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- El-Kahlout Sahar
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- Elbealawy Mohamed
- Elbeshina Aya Elseed
- Elblbessy Mahmood
- Eldeep Ahmed
- Eldeep Mostafa
- Eldmaty Asmaa
- Eldoseuky mohammed Amany
- Elemile Peter
- Elewaily Mohamed Ibrahim Elsayed
- Elfaituri Taha
- Elfallal Ahmed
- Elfanty Mahmoud
- ElFayoumy Ahmed Moustafa
- Elfeki Hossam
- Elfizri Zatira
- Elgammudi Mala
- Elghareeb Nourhan
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- Elhadi Muhammed
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- Elshawy Mohamed Elemam
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- Fairfield Cameron J
- Falato Armando
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- M R Rashmi
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- McManus Brendan
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- NA N.A.
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- Nsengiyumva Carlos
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- Obaid Mohammed
- Obery Gareth
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- Ogundoyin Olakayode
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- Wondoh Paul M.
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- Ye Geoffrey
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- Yenli Edwin
- Yeo Jeremy
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- Yusuf Baasil
- Yüksel Osman
- Zabiyaka Mikhail
- Zachariah Sanoop Koshy
- Zafar Syed Nabeel
- Zaffaroni Gloria
- Zahra Baryab
- Zahran Diaaaldin
- Zakaria Andee Dzulkarnaen
- Zakaria Mai
- Zakaria Omar
- Zakaria Zaidi
- Zambrana Campos Vanesa
- Zammit Matthew
- Zanini Nicola
- Zara Vlu Jean
- Zara Vlu Jean
- Zarti Heba
- Zarzycki Piotr
- Zattoni Davide
- Zavala Gabriela
- Zawahrah Hassan
- Zeiton Asaid
- Zeko Amanda
- Zeng Zhi
- Zeromskas Paulius
- Zhang Geoffrey
- Zhivkov Evgeni
- Zid Esraa
- Zidan Ahmed Mohy
- Zielasek Christian
- Zilinskas Justas
- Zimmermann Bernd
- Ziprin Paul
- Zizzo Maurizio
- Zografos George
- Zoikas Athanasios
- Zorrilla Matilla Laura Patricia
- Zoulamoglou Menelaos
- Zreeg Dafer
- Zub-Pokrowiecka Anna
- Zubiaurre Vanessa
- Zuhdy Mohammed
- Zuikyte Diana
- Zuloaga Fernandez del Valle Carlos Jose
- Zulu Stanley
- Ângelo Miguel
- Älgå Andreas
- Çolak Elif
- Ümarik Toomas
- Šatkauskas Mindaugas
- Škimelyte Monika
- Šlenfuktas Vygintas
- Šuman Oliver
- Žatecký Jan
- Žumbakys Žygimantas
- Župan Domagoj
- Publication venue
- 'Elsevier BV'
- Publication date
- 30/01/2021
- Field of study
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
- Author
- A Yacoub Mina
- A. Adam Mohammed
- A. Nassar Mahmoud
- A.Nemer Ayoob
- Aahlin Eirik Kjus
- Ab Rahim Mohd Fadliyazid
- Abad Gurumeta Alfredo
- Abad-Motos Ane
- Abang Jamari Dyg Zahratul Hamrak
- Abantanga Francis
- Abarca Sol
- Abazid Eias
- Abbas Abbas
- Abbas Khalid
- Abbas Mohammad Monir
- Abbasy Jibran
- Abbosh Ali
- Abd Karim Muhammad Fairuz Shah
- Abd Wahab Haidar Hadri
- Abd Barook
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- Dominguez Joaquina
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- Ghaly Khaled
- Ghellai Ali M.
- Ghonaim Mennatullah
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- Pramesh C.
- Prasad Uday
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- Wisselink Daan
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- Wondoh Paul M.
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- Yaghi Yasmine
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- Yanikoğlu Erkan
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- Yates Charlotte
- Ye Geoffrey
- Yeen Chin Leow
- Yemez Kürşat
- Yenidünya Nilüfer
- Yenli Edwin
- Yeo Jeremy
- Yeoh Andrea
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- Yeşilsancak Merve
- Yildirim Reyyan
- Yildiz Alp
- Yilmaz Duygu
- Yip Ching Wan
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- Yong Shun Qi
- Yoong Andrel
- Yorke Joseph
- Yotsov Tsanko
- You Lucia
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- Yozgatli Tahir Koray
- Yu Kristin
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- Yusuf Baasil
- Yüksel Osman
- Zabiyaka Mikhail
- Zachariah Sanoop Koshy
- Zafar Syed Nabeel
- Zaffaroni Gloria
- Zahra Baryab
- Zahran Diaaaldin
- Zakaria Andee Dzulkarnaen
- Zakaria Mai
- Zakaria Omar
- Zakaria Zaidi
- Zambrana Campos Vanesa
- Zammit Matthew
- Zanini Nicola
- Zara Vlu Jean
- Zarti Heba
- Zarzycki Piotr
- Zattoni Davide
- Zavala Gabriela
- Zawahrah Hassan
- Zeiton Asaid
- Zeko Amanda
- Zeng Zhi
- Zeromskas Paulius
- Zhang Geoffrey
- Zhivkov Evgeni
- Zid Esraa
- Zidan Ahmed Mohy
- Zielasek Christian
- Zilinskas Justas
- Zimmermann Bernd
- Ziprin Paul
- Zizzo Maurizio
- Zografos George
- Zoikas Athanasios
- Zorrilla Matilla Laura Patricia
- Zoulamoglou Menelaos
- Zreeg Dafer
- Zub-Pokrowiecka Anna
- Zubiaurre Vanessa
- Zuhdy Mohammed
- Zuikyte Diana
- Zuloaga Fernandez del Valle Carlos Jose
- Zulu Stanley
- Ângelo Miguel
- Älgå Andreas
- Çolak Elif
- Ümarik Toomas
- Čepuliené Daiva
- Şahin Can
- Šatkauskas Mindaugas
- Škimelytè Monika
- Šlenfuktas Vygintas
- Šuman Oliver
- Žatecký Jan
- Žumbakys Žygimantas
- Župan Domagoj
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/07/2022
- Field of study
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: 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. Funding: National Institute for Health and Care Research