12 research outputs found
Anticancer Activities of Thymus vulgaris L. in Experimental Breast Carcinoma In Vivo and In Vitro
- Author
- Publication venue
- 'MDPI AG'
- Publication date
- 01/04/2019
- Field of study
Naturally-occurring mixtures of phytochemicals present in plant foods are proposed to possess tumor-suppressive activities. In this work, we aimed to evaluate the antitumor effects of Thymus vulgaris L. in in vivo and in vitro mammary carcinoma models. Dried T. vulgaris (as haulm) was continuously administered at two concentrations of 0.1% and 1% in the diet in a chemically-induced rat mammary carcinomas model and a syngeneic 4T1 mouse model. After autopsy, histopathological and molecular analyses of rodent mammary carcinomas were performed. In addition, in vitro evaluations using MCF-7 and MDA-MB-231 cells were carried out. In mice, T. vulgaris at both doses reduced the volume of 4T1 tumors by 85% (0.1%) and 84% (1%) compared to the control, respectively. Moreover, treated tumors showed a substantial decrease in necrosis/tumor area ratio and mitotic activity index. In the rat model, T. vulgaris (1%) decreased the tumor frequency by 53% compared to the control. Analysis of the mechanisms of anticancer action included well-described and validated diagnostic and prognostic markers that are used in both clinical approach and preclinical research. In this regard, the analyses of treated rat carcinoma cells showed a CD44 and ALDH1A1 expression decrease and Bax expression increase. Malondialdehyde (MDA) levels and VEGFR-2 expression were decreased in rat carcinomas in both the T. vulgaris treated groups. Regarding the evaluations of epigenetic changes in rat tumors, we found a decrease in the lysine methylation status of H3K4me3 in both treated groups (H3K9m3, H4K20m3, and H4K16ac were not changed); up-regulations of miR22, miR34a, and miR210 expressions (only at higher doses); and significant reductions in the methylation status of four gene promoters—ATM serin/threonine kinase, also known as the NPAT gene (ATM); Ras-association domain family 1, isoform A (RASSF1); phosphatase and tensin homolog (PTEN); and tissue inhibitor of metalloproteinase-3 (TIMP3) (the paired-like homeodomain transcription factor (PITX2) promoter was not changed). In vitro study revealed the antiproliferative and proapoptotic effects of essential oils of T. vulgaris in MCF-7 and MDA-MB-231 cells (analyses of 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) (MTS); 5-bromo-20-deoxyuridine (BrdU); cell cycle; annexin V/PI; caspase-3/7; Bcl-2; PARP; and mitochondrial membrane potential). T. vulgaris L. demonstrated significant chemopreventive and therapeutic activities against experimental breast carcinoma
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
- Aljanadi Firas
- Aljiffry Murad
- Aljirdabi Noof
- Alkahlan Mohammed
- Alkhalifa Elmustafa
- Alkhatib Sondos
- Alkhatieb Maram
- Allan Anna
- Almarshad Felwa
- Almgla Naser
- Almhimid Ali
- Almiqlash Bushray
- Almoshantaf Mohammad Badr
- Almutairi Abdulmjeed
- Alnsour Abed Alfattah Mahmoud
- Alobied Majd
- Alomar Osama
- Alonso Jesús Aarón Martínez
- Alonso Manuel Diez
- Alonso Nestor Fabian Pedraza
- Alonso Veronica
- Alqallaf Abdullah
- Alqaseer Asma
- Alrayes Bourhan
- Alsefri Maryam
- Alser Osaid
- Alsharif Mohammed
- Alsori Mohamed
- Altaf Abdulmalik
- Altinel Yuksel
- Altiner Saygin
- Altouny Ahmad
- Altun Demet
- Alvarez Natalia
- Alvarez-Lozada Luis Adrian
- Alvi Abdul
- Alwael Athari
- Alwash Mohammed
- Alyami Ziyad
- Alyousef Mohammed
- Alzahrani Saud
- Alzerwi Nasser
- Amin Shivang
- Amir Mohammed
- Ammar Ahmed Siddique
- Ammendola Michele
- Amores Remedios Revilla
- Amrayev Sultan
- Anastasiadou Sofia
- Ancans Guntis
- Anderson Caroline
- Andreani Lorenzo
- Andreotti Dario
- Andreuccetti Jacopo
- Andrianakis Alexandros
- Andro Christophe
- Anesi Alexandre
- Angamuthu Stephen
- Angeles Martina Aida
- Angelico Roberta
- Angelis Fragkiskos
- Angelou Dimitrios
- Angelou Kyveli
- Angulo Victor Pinto
- Anjum Arfa
- Anjum Muhammad Ayyub
- Annicchiarico Alfredo
- Anoldo Pietro
- Ansaloni Luca
- Anthoulakis Christos
- Antonelli Amedeo
- Anwar Mohamed
- Anwar Sumadi Lukman
- Anwer Mariyah
- Anyanwu Lofty-John
- Apostolou Christos
- Apostolou Konstantinos
- Appiah-Kubi Adu
- Aprea Giovanni
- Arbab Hana
- Archer James
- Ardura Francisco
- Aremu Muyiwa
- Arif Tahera
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- Armatura Giulia
- Armijos Daniel
- Arnaout Ali
- Arnaoutoglou Eleni
- Arnaud Alexis P.
- Arneja Jugpal
- Arrangoiz Rodrigo
- Arshad Muhammad
- Arthur Joshua
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- Ashraf Fariha
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- Asirifi Samuel Amoako
- Asla Amir
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- Ataya Karim
- Ateca Ibabe Villalabeitia
- Atici Semra Demirli
- Atis Gokhan
- Atkins William
- Atkinson Kate
- Attwood Joseph
- Auerkari Aino
- Augestad Knut Magne
- Augustin Goran
- Aujayeb Avinash
- Avella Pasquale
- Awad Ahmed K.
- Awad Hadeel
- Awad Rabih
- Awad Selmy
- Ayad Kusay
- Ayana Birhanu
- Aydin Yener
- Ayeni Funbi
- Aytac Erman
- Azab Ahmed
- Azami Rizwan
- Azize Diallo Abdoul
- Azzam Ahmed Y.
- Azzis Olivier
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- Balogh Zsolt J.
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- Balogun Simon
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- Ezeme Constantine
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- Thuduvage Vasanthika
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- Tian Sarah
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- Tomasicchio Giovanni
- Tomlinson James
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- Tottman R.
- Tousidonis Manuel
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- Tucker Olga
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- Vaschetti Roberto
- Vassiliu Panteleimon
- Vatansever Dogan
- Vatish Jamie
- Vaughan-Shaw Peter G.
- Vaysburg Dennis
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- Velázquez Maria Jose Martinez
- Venkatappa Sunil Kumar
- Venketeswaran Meenakshi
- Venskutonis Donatas
- Verbic Milena Senica
- Verdi Daunia
- Vergara-Fernandez Omar
- Verhoeff Kevin
- Veroux Massimiliano
- Verras Georgios-Ioannis
- Verre Luigi
- Vida Lucian
- Vidya Raghavan
- Viglietta Edoardo
- Vijay Vardhini
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- Vilaró Blanca Capdevila
- Villanueva Julio
- Vilz Tim O.
- Vincent Elizabeth
- Vinci Danilo
- Viola Simona
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- Vishnoi Jeewan Ram
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- Vivancos Laura Guillamon
- Vives Josep Maria Muñoz
- Vizzielli Giuseppe
- Vohra Lubna
- Vokshi Ismail
- Vosinakis Christos
- Vásquez Javier Alberto Gutiérrez
- Vázquez Gil
- Vázquez Irene Ortega
- Vǎcǎraşu Andrei Bogdan
- Wade Ryckie
- Wafi Omar
- Wagner Gabriela
- Wallis Christopher
- Wanjara Samuel
- Waqar Shahzad Hussain
- Warden Claire
- Warner Christian
- Wasim D.
- Wason Shaun
- Wasserman Isaac
- Watcyn-Jones Tom
- Waterson Ben
- Watson David
- Watson Matthew
- Weber Clemens
- Wheatstone P.
- Wheeler James
- Wheldon Luke
- White Michelle
- White Stuart
- White William
- Wickramasinghe Dakshitha
- Widmer Lukas Werner
- Wiedemann Dominik
- Wiesinger Clemens Georg
- Wijekoon Naveen
- Wijenayake Wasantha
- Wijeyaratne Manuk
- Wijeysundera Duminda
- Wiles Matthew
- Wilkin Richard
- Wilkins Alex
- Wilkins James
- William Tinka George
- Williams Omolara Modupe
- Williams Shekinah
- Windsor John
- Winnand Philipp
- Wittmann Maria
- Wolde Amanuel
- Wolfenden John W. D.
- Wong Benjamin Ngie Xiong
- Wong Enoch
- Wong Evan G.
- Wong George Kwok Chu
- Wong Ho Ying Flora
- Wong Kai Yuen
- Wormald Justin
- Wright Deborah
- Wright Joshua
- Wu Fiona
- Wurm Markus
- Xenaki Sofia
- Yadev Ip
- Yahaya Ahmad Shuib
- Yakubu Mustapha
- Yang Wah
- Yanik Özge
- Yanowsky-Reyes Guillermo
- Yassin Abubaker
- Yates Elizabeth
- Yebes Alvaro
- Yenli Edwin Mwintiereh Ta-Ang
- Yeoh Tien
- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Ocular surface reconstruction: recent innovations, surgical candidate selection and postoperative management
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- Adeghate
- Ainsworth
- Anderson
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- Kruse
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- Nishida
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- Oberhansli
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- Ozdemir
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- Park
- Pellegrini
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- Pflugfelder
- Pho Nguyen
- Puangsricharern
- Rama
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- Rao
- Reinhard
- Reinhard
- Reinhard
- Resch
- Samson
- Samuel C Yiu
- Sangwan
- Sangwan
- Saw
- Schechter
- Schermer
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- Selvam
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- Selvam
- Shimazaki
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- Shimazaki
- Shimazaki
- Shimazaki
- Shimazaki
- Sloper
- Solomon
- Solomon
- Solomon
- Sundmacher
- Szurman
- Tamhane
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- Theng
- Thoft
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- Tomita
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- Tsai
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- Tseng
- Tseng
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- Tsubota
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- Tsubota
- Tsubota
- Tsubota
- Uy
- Weisbach
- Wylegala
- Yao
- Yiu
- Yokoo
- Zhou
- Zoukhri
- Publication venue
- 'Informa UK Limited'
- Publication date
- Field of study
Microvesicles in Health and Disease
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- A Ginestra
- A Janowska-Wieczorek
- A Janowska-Wieczorek
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- A Khiati
- A MacKenzie
- A Maizel
- A Nagai
- A Pelchen-Matthews
- A Piccin
- A Rubartelli
- A Sarkar
- A Scanu
- A Tomas
- AC Matzdorff
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- AL Edinger
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- C Friend
- C Grange
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- CK Taranger
- D Lutomski
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- DL Bratton
- DM Smalley
- E Chargaff
- E Hind
- E Pap
- EA Ansa-Addo
- EA Berger
- EA Eugenin
- EH Cheng
- EM Bevers
- Ephraim A. Ansa-Addo
- ER Vandendries
- F Basse
- FF Doormaal van
- G Andreola
- GG Borisenko
- HA Mostefai
- HH Hsu
- HK Kim
- I Conde Del
- I Prudovsky
- IM Rood
- J Hakulinen
- J Nilsson
- J Qu
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- JE Fox
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- JF Chen
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- JH Distler
- JI Zwicker
- JJ Cohen
- JL Spees
- JM Freyssinet
- JM Yingling
- JN George
- JT Do
- JW Bess Jr
- JW Kim
- K Hochedlinger
- K Jacobson
- K Shedden
- KG Gaustad
- KK Hamilton
- L Alvarez-Erviti
- L Tailleux
- LE Graves
- LG Lima
- LL Horstman
- M Baj-Krzyworzeka
- M Baj-Krzyworzeka
- M Baj-Krzyworzeka
- M Herrmann
- M Mack
- M Majka
- M Majka
- M Majka
- M Samson
- M Wysoczynski
- MA Antonyak
- MB Whitlow
- MC Deregibus
- MC Lee
- MC Martinez
- MD Shah
- MJ VanWijk
- ML Albert
- MN Abid Hussein
- N Amabile
- N Aoki
- N Brechot
- N Böing
- N Satta
- O Gasser
- O Gasser
- OP Barry
- OP Barry
- P Butikofer
- P Cherian
- P Wolf
- PJ Sims
- PL McNeil
- R Grant
- R Safaei
- R Valenti
- RC Hughes
- RF Zwaal
- RZ Florkiewicz
- S Antwi-Baffour
- S Nolan
- S Omoto
- S Sadallah
- S Segerer
- Samireh Jorfi
- Samuel S. Antwi-Baffour
- Sharad Kholia
- Sigrun Lange
- SJ Gould
- SK Halder
- T Scholz
- U Putz
- U Rauch
- V Combes
- V Huber
- V Muralidharan-Chari
- VA Fadok
- VM Abrahams
- W Jy
- W Nickel
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- X Niu
- Z Mallat
- Publication venue
- 'Springer Science and Business Media LLC'
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- BELL
- BELLI
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- SEHGAL
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- SENEVIRATNE
- SERJEANT
- SERJEANT
- SERJEANT
- SERRANO
- SETH
- SEVERIN
- SEVERIN
- SEVERIN
- SEVERIN
- SEVERIN
- SHEFFIELD
- SHEFFIELD
- SHEFFIELD
- SHEFFIELD
- SHEPARD
- SHEPHERD
- SHEPHERD
- SHEPHERD
- SHEPHERD
- SHIKATA
- SHIKATA
- SHIKATA
- SHIKATA
- SHIKATA
- SHIKATA
- SHIKATA
- SHIKATA
- SHUKLA
- SILBERSCHMIDT
- SILBERSCHMIDT
- SILBERSCHMIDT
- SILBERSCHMIDT
- SILBERSCHMIDT
- SILL
- SILL
- SILVA
- SINAH
- SINGH
- SINGH
- SINGH
- SINGH
- SINGH
- SINGH
- SINHA
- SINHA
- SINHA
- SINHA
- SINHA
- SINHA
- SINHA
- SINHA
- SKOTLAND
- SLEETH
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SLYKHUIS
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SMITH
- SNYDER
- SOMMEREYNS
- SOUKHOV
- SPIERENBURG
- SPIRE
- SPIRE
- SREENIVASAN
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STACE-SMITH
- STAHL
- STANLEY
- STANTON
- STAPLES
- STEERE
- STEERE
- STEERE
- STEGWEE
- STEINDL
- STELLMACH
- STONE
- STONER
- STONER
- STONER
- STOREY
- STOREY
- STOREY
- STOREY
- STOREY
- STOREY
- STOREY
- STOREY
- STOREY
- STOREY
- STOREY
- STORY
- STOVER
- STREISSLE
- STUBBS
- STUBBS
- STUBBS
- STUBBS
- SUMMANWAR
- SUTIC
- SUTTON
- SWINGLE
- SWINGLE
- SYLVESTER
- SYLVESTER
- SYLVESTER
- SYLVESTER
- SYLVESTER
- SYLVESTER
- SYLVESTER
- SYLVESTER
- SYMONS
- SYNDER
- T
- TAKAHASHI
- TANAKA
- TARR
- TARR
- TATE
- TAYLOR
- TAYLOR
- TAYLOR
- TAYLOR
- TAYLOR
- TAYLOR
- TAYLOR
- TAYLOR
- TEAKLE
- TEAKLE
- TEAKLE
- TEAKLE
- TEAKLE
- THOMAS
- THOMAS
- THOMAS
- THOMAS
- THOMAS
- THOMAS
- THOMSON
- THORNBERRY
- THORNBERRY
- THOTTAPILLY
- THOTTAPILLY
- THRESH
- THUNG
- THUNG
- TINSLEY
- TINSLEY
- TOCHIHARA
- TOCHIHARA
- TODD
- TODD
- TODD
- TOLLIN
- TOMLINSON
- TOMLINSON
- TOMLINSON
- TOMLINSON
- TOMLINSON
- TOMPKINS
- TOMPKINS
- TOMPKINS
- TOMPKINS
- TOMPKINS
- TOŠIĆ
- TRAVERSI
- TREMAINE
- TREMAINE
- TROUTMAN
- TSUGITA
- TURNER
- TURNER
- UPPAL
- UPPAL
- UYEMOTO
- VACKE
- VALLEAU
- VALLEAU
- VAN DER WANT
- VAN HOOF
- VAN HOOF
- VAN HOOF
- VAN KAMMEN
- VAN KAMMEN
- VAN KAMMEN
- VAN KATWIJK
- VAN KATWIJK
- VAN KATWIJK
- VAN KATWIJK
- VAN KATWIJK
- VAN KATWIJK
- VAN KOOT
- VAN NIEKERT
- VAN OOSTEN
- VAN OOSTEN
- VAN REGENMORTEL
- VAN SLOGTEREN
- VAN SLOGTEREN
- VAN VELSEN
- VAN VELSEN
- VAN VELSEN
- VAN VELSEN
- VAN VLOTEN-DOTING
- VANDERVEKEN
- VANDERWALLE
- VARMA
- VARMA
- VARMA
- VARMA
- VARMA
- VARMA
- VARMA
- VARNEY
- VASUDEVA
- VERMA
- VERMA
- VERMA
- VERPLANCKE
- VERPLANCKE
- VIDANO
- VIDANO
- VIDANO
- VIDANO
- VIDANO
- VON FRITZCHE
- WADE
- WAGNON
- WALKER
- WALKER
- WALKER
- WALKEY
- WALKEY
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALLACE
- WALTERS
- WALTERS
- WALTERS
- WALTERS
- WALTERS
- WARMKE
- WARMKE
- WATERWORTH
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WATSON
- WEATHERS
- WEATHERS
- WEATHERS
- WEATHERS
- WEATHERS
- WEATHERS
- WEATHERS
- WEBB
- WEBB
- WEBB
- WEBER
- WEIMER
- WEINTRAUB
- WEINTRAUB
- WELLMAN
- WELLMAN
- WELLMAN
- WELLMAN
- WELLS
- WELSH
- WELSH
- WELSH
- WENZL
- WETTER
- WETTER
- WETTER
- WETTER
- WHITCOMB
- WHITE
- WHITE
- WILCOX
- WILDE
- WILKES
- WILKINSON
- WILKINSON
- WILKINSON
- WILLE
- WILLIAMS
- WILLISON
- WILLISON
- WILLISON
- WILSON
- WINGARD
- WOLANSKI
- WOLF
- WOLF
- WOLFSWINKEL
- WOLFSWINKEL
- WOODS
- WRIGHT
- YAMADA
- YARWOOD
- YARWOOD
- YARWOOD
- YOSHII
- YOSHII
- ZAITLIN
- ZAUMEYER
- ZAUMEYER
- ZAUMEYER
- ZAUMEYER
- ZAUMEYER
- ZAUMEYER
- ZAUMEYER
- ZAUMEYER
- ZELLER
- ZELLER
- ZELLER
- ZELLER
- ZELLER
- ZELLER
- ZELLER
- ZELLER
- ZETTLER
- ZETTLER
- ZINK
- ČECH
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/1972
- Field of study
Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial
- Author
- Aakre Elin
- Aasmundstad Tor
- Abbott Tom
- Accurso Giuseppe
- Adams Benita
- Aduse-Poku Maame
- Aherne Caroline
- Ahmad Tahania
- Ahmed Mamoona
- Akeroyd Louise
- Aksnes Einar
- Al-Kadhimi Samuel
- Alampi Daniela
- Alcock Harry
- Alcorn David
- Aldecoa Cesar
- Alexander-Sefre Farhad
- Allan Ashley
- Allana Alisha
- Allen Jonathan
- Allison Joanna
- Alpers Lise-Merete
- Aluri Sireesha
- Amaral Vanessa
- Andersen Nina
- Andrade Edward
- Andreou Prematie
- Anker Robert
- Antonelli Massimo
- Arnold Glenn
- Asis Gretchelle
- Asvall Joerund
- Atterbury Katie
- Awolesi Jennifer
- Babio-Galan Maite
- Babu Sheeba
- Bacciarelli Samantha
- Baillie Kirsty
- Bakke Monica
- Balint Mihaela
- Ballinger Sarah
- Bamford Amy
- Baratozzi Valentina
- Barker Helen
- Barnes Veronica
- Barraclough Lauren
- Barratt Nina
- Barratt-Due Andreas
- Batuwitage Bisanth
- Bean Sarah
- Begum Salma
- Bekele Soliana
- Bell Joanne
- Bell Paula
- Bellini Valentina
- Benavente Melissa
- Benyon Sarah
- Bergin Colin
- Berridge John
- Bertellini Elisabetta
- Bertolotti Valentina
- Betts Rebecca
- Bhagwan Kamal
- Biccard Bruce
- Bignami Elena
- Birch Sian
- Biyase Thuli
- Bjoern\ue5 Gunhild
- Black Ethel
- Blunt Mark
- Boardman Victoria
- Bowman Katie
- Bradley Isabel
- Branney Debbie
- Brattstrom Olof
- Brennan Andrew
- Bridger Hayley
- Brioni Matteo
- Bruni Andrea
- Buckley David
- Bull Christopher
- Buono Antonio
- Burns Karen
- Burt Karen
- Cahill Hazel
- Cain Martyn
- Calcinati Serena
- Calder Verity
- Calli Morena
- Campey Lorraine
- Cardinale Daniela
- Cardoso Sean
- Carling Natalie
- Carnahan Mandy
- Carrera Ronald
- Carrick Mike
- Carvelli Paula
- Cashmore Richard
- Casotto Giulia
- Castagna Luigi
- Chadderton Ian
- Chattersingh Anjalee
- Chau Simon
- Chew Michelle
- Chironga Nyasha
- Chishti Ahmad
- Chiumello Davide
- Chukkambotla Srikanth
- Clark Richard
- Clarke Heidi
- Clayton Matt
- Coetzee Ettienne
- Coetzee Samantha
- Colling Kerry
- Colville Gary
- Conneely Leonora
- Conway Daniel
- Cooper Deborah
- Cooper Lauren
- Cooper Sarah
- Cope Sean
- Corcione Antonio
- Cornell Sarah
- Correia Carmen
- Corso Ruggero
- Cosgrove Joseph
- Cossu Andrea
- Cranshaw Julius
- Cromie Terri-Louise
- Crooks Jennifer
- Cullen Katherine
- Cunningham Mishell
- Curci Maria
- Cutuli Salvatore
- Dahl Anita
- Dalton Carol
- Dalton Claire
- Daly Zoe
- Daniels Allison
- Darai Giulia
- Daum Peter
- Davies Louise
- Day Christopher
- Daysal Gokce
- De Bois Jessica
- De Leonardis Brunella
- De Prada-Mart\uedn Blanca
- Deacon Bethan
- Delgado Carlos
- Della Giovampaola Maria
- Despy Liesl
- Dias Priyanthi
- Dickinson Matthew
- Dickinson Natalie
- Didriksson Helen
- Doble Patricia
- Donatiello Maria
- Doyle Donna
- Doyle Nancileigh
- Drummond Leanne
- Duberley Stephen
- Dunkley Steven
- Dunn Leigh
- Duys Rowan
- Dvorkin Lee
- Eddy Sara
- Edwards Jennifer
- Edwards Mark
- Edwards Zara
- Eeles Alex
- El\uedas Elisa
- Ellinor Katharine
- Ellis Karen
- Ellis Kaytie
- Evans Matthew
- Everett Mary
- Ezihe-Ejiofor Adanma
- Ezihe-Ejiofor Adanma
- Fanigliulo Maria
- Farina Zane
- Farnell-Ward Sarah
- Farrah Helen
- Faulds Matthew
- Feben Alex
- Feldt Linda
- Fellows Emma
- Fernandez Maria
- Ferrando Carlos
- Ferrari Erica
- Figari Elisa
- Filipe Helder
- Filippini Claudia
- Fitchett Jill
- Fl\ue5ten Eva
- Fladby Hege
- Fleming Lorna
- Flint Margot
- Flint Neil
- Flodberg Magnus
- Floris Leda
- Forfori Francesco
- Forshaw Greg
- Fortune Jonathan
- Foti Giuseppe
- Fowler Alexander
- Fuller Tracy
- Fulton Laura
- Furlani Stefano
- G\uf3mez-Herreras Jos\ue9
- Gannon Lizzie
- Garcia Amaia
- Gardner Matthew
- Garofalo Eugenio
- Gazzanelli Sergio
- Genetu Roman
- Gerstman Michelle
- Giarratano Antonino
- Gibson Andy
- Gleeson Yvonne
- Glennon Julia
- Goellner Sarah
- Goundry Stephanie
- Graham Laura
- Grainger Lia
- Granheim Karen
- Grasselli Giacomo
- Grassi Alice
- Graterol Juan
- Gray Geraldine
- Greaves Kathryn
- Green Adam
- Green Samantha
- Greenshields Nicole
- Greig Louise
- Gresty Jo
- Grice Anna
- Griffiths Bethan
- Griffiths Ewen
- Guerra Yessica
- Gumede Simphiwe
- Gunter Una
- Hagring Minna
- Haines Ryan
- Hales Dawn
- Hall Kathryn
- Hamilton Emma
- Hamilton Mark
- Hamlyn Vincent
- Hammonds Fiona
- Hanley Janice
- Hannaway Carol
- Harkett Samantha
- Harrison Abigail
- Harrison-Briggs Donna
- Harvey Alice
- Harvey Eleanor
- Haslop Richard
- Haugaa H\ue5kon
- Hausken John
- Hawes Elizabeth
- Hays Carole
- Hegarty Aoife
- Hegarty Aoife
- Heggelund Bente
- Henderson Steven
- Hepworth David
- Hester Natalie
- Hewson Russell
- Hodgkinson Sheila
- Hodgson Ruth
- Hodkinson Gemma
- Hoel Sindre
- Hoivik Tone
- Holmes Ann
- Hope Susan
- Hornzee Gillian
- Howard Kate
- Howarth Rachel
- Howe Gwenllian
- Howlett Luisa
- Howson Alex
- Hu Ying
- Hudson Karen
- Hughes Christina
- Hui Sarah
- Hutchinson Jenna
- Hutter Joanne
- Ibrahim Mohamed
- Ilyas Carl
- Innes Richard
- Iotti Giorgio
- Ip Peter
- Ivatt Helen
- Jackson Christine
- Jackson Matthew
- James Katherine
- Jammer Ib
- Januszewska Marta
- Jenner Katy
- Jhanji Shaman
- Jigajinni Suyogi
- Jogi Summayyah
- Johnston Paul
- Jones Gerry
- Jones Leanne
- Jorge-Monjas Pablo
- Joseph Gipsy
- Joubert Ivan
- Kahan Brennan
- Kanakaraj Muthuraj
- Kang Soo
- Kasipandian Vidya
- Kasivisvanathan Ramanathan
- Kaur Jasmin
- Kelliher Leigh
- Kelly Sin\ue9ad
- Kent Alissa
- Kibaru Joyce
- Kidel Carlos
- King James
- Kinghorn Stephen
- Kipling Sarah
- Kirk-Bayley Justin
- Kjoesen Gisle
- Klaevahaugen Inge
- Kouridaki Christina
- Krupa Monika
- Kubisz-Pudelko Agnieszka
- Kumar Ram
- Kunst Gudrun
- Kusel Belinda
- Laha Shondipon
- Laklouk Muhammad
- Latif Ahmed
- Lawrence Helen
- Lawton Tom
- Le Poidevin Alison
- Leaver Susannah
- Lee Aaron
- Leitch Andrew
- Lenz Harald
- Leo Alessandra
- Leonard Dee
- Letts Maria
- Lewszuk Adam
- Lynch Ceri
- M\ue5nsson Sandra
- Macedo Joao
- Macfie Caroline
- Mackle Daisy
- Macmillan Josep
- Macrow Christopher
- Maher Karen
- Mahjoob Parisa
- Makowski Arystarch
- Malik Ihtisham
- Manhas Vitul
- Manon Vasi
- Maria Jashmin
- Mariano Victor
- Marsh Veronica
- Martin Tim
- Mason Tracy
- Matthews Laura
- May Shaun
- Mazzola Francesca
- Mbuyisa Mbalenhle
- McArthur Carol
- McAuley Danny
- McCanny Jamie
- Mccullagh Iain
- McGhee Christopher
- McGovern Clare
- McIlveen Erin
- McKay Emma
- McLaughlin Aisling
- McLeavy Laura
- McNeil Margaret
- Mellinghoff Johannes
- Melody Teresa
- Mezzapesa Mario
- Mingo Sara
- Minicozzi Annamaria
- Mistraletti Giovanni
- Molina Esther
- Monk Jade
- Monks Kathleen
- Montague Laura
- Montini Luca
- Montoya-Pelaez Felipe
- Morrison Ben
- Moug Susan
- Mowatt Chris
- Mullenheim Jost
- Munro Michael
- Murphy Anthony
- Murphy Zoe
- Myhre Marianne
- Navalesi Paolo
- Navsaria Pradeep
- Nazari Roonak
- Neal Aoife
- Neep Adam
- Nesbitt Ian
- Nicholson Alice
- Niebrzegowska Edyta
- Nightingale Jeremy
- Nilsson Malin
- Noble Harriet
- Norman Chloe
- Northey Martin
- Nutt Chris
- O'Mahony Michelle
- O'Neil Suzanne
- O'Neill Orla
- Ogbeide Vongayi
- Oguntimehin Rachel
- Oliveira Monica
- Oram Shaun
- Organ Angie
- Orrem Hilde
- Pakats Mari-Liis
- Pakou Glykeria
- Palmaverdi Valentina
- Pang Ching Ling
- Pappa Evita
- Park Linda
- Parker Jane
- Parkinson David
- Patel Akshaykumar
- Patel Jaimin
- Patel Panna
- Pates Katherine
- Pathmanathan Byiravey
- Pawley Corinne
- Payne Sara
- Peacock Victoria
- Pearse Rupert
- Peetamsingh Andrew
- Penhaligon Bethany
- Pereira Joel
- Perman Chris
- Peters Steven
- Phillips Alex
- Phoenix Catherine
- Picchioni Raffaella
- Picken Guy
- Piervincenzi Edoardo
- Pinto Manuel
- Pippard Lucy
- Piredda Davide
- Pirie Katrina
- Pischke Soeren
- Pitts Sally
- Poma Silvia
- Pomeroy Fiona
- Pope Martin
- Porrill Owen
- Porter Stephanie
- Potter Elizabeth
- Prabhahar Thaventhran
- Priani Paolo
- Prior Florence
- Pritchard Naomi
- Pye Kate
- Quamina Charlotte
- Quraishi Tanviha
- Racca Alberto
- Radley Lydia
- Ragazzi Riccardo
- Raineri Santi
- Rajah Chantal
- Ramkillawan Arisha
- Ramsamy Nirmalabaye
- Ramsaran Richard
- Rangaswamy Girish
- Ranieri Marco
- Rao Baikady Ravishankar
- Reeves Eleanor
- Reite Mads
- Rhodes Andrew
- Richards Nicole
- Rico-Feijoo Jesus
- Righi Claudia
- Roberts Emma
- Roberts Lindsey
- Robinson Frances
- Rocco Monica
- Roche Lisa
- Rodr\uedguez-Jim\ue9nez Rita
- Rodseth Reitze
- Roertveit Linda
- Romero Esther
- Rooms Martin
- Rosbergen Melissa
- Rossi Giuseppe
- Routledge Jacki
- Ryan Christine
- Salberg Armorel
- Salmaso Marco
- Sampson Julia
- Samson Craig
- Sander Caroline
- Santos Filipa
- Savino Martina
- Scott Carmen
- Seidel Philipp
- Sethi Sahiba
- Settesoldi Giacomo
- Shah Nirav
- Shahid Tasnin
- Sheriff Julie
- Shirley Paula
- Shovel Louisa
- Shrestha Tara
- Sibley Pauline
- Sibug Sheena
- Simili Paolo
- Singh Rita
- Sinha Aneeta
- Sira James
- Sivadhas Harry
- Sivarajan Sinduja
- Skene Simon
- Smith Hazel
- Smith Lorna
- Smithson Beth
- Snelson Catherine
- Solala Sivuyisiwe
- Sollesta Kathryn
- Somerville Alastair
- Soria-Garc\ueda Mar\ueda
- Soulsby Graham
- Spadaro Savino
- Spencer William
- Spimpolo Jennifer
- Spruce Elaine
- Stamper Sean
- Stapleton Claire
- Stephens Tim
- Stickley Jo
- Stitt Emily
- Stokes-Denson Jo
- Strathie Grant
- Strudwick Rhea
- Subhedar Emily
- Sutton Peter
- Swain Andrew
- Sweeting Helen
- Syddall Stuart
- Szakmany Tamas
- Tait Moira
- Tait Rebecca
- Tammaro Marcello
- Tan Evalyn
- Tatham Kate
- Taylor Jenna
- Tellan Guglielmo
- Terragni Pierpaolo
- Thomas Marie
- Thomas Peter
- Thomson Milo
- Tibke Clare
- Toennessen Tor Inge
- Tooth David
- Torborg Alexandra
- Tricoli Giuseppe
- Uddin Ruzena
- Uren Sophie
- Uttamlal Trishna
- Veenith Tonny
- Verlander Mark
- Verri Marco
- Vezyrgiannis Marios
- Vigo Ylenia
- Villa Silvia
- Vincent Rachel
- Vohra Ravinder
- Volta Carlo
- von Rahden Richard
- Wakeford Nichola
- Walker Laura
- Walker Sophie
- Walker Susanna
- Walton Jon
- Wan Yize
- Ward Sinead
- Watt Ailsa
- Whalley Jan
- White Thomas
- Whitehouse Arlo
- Whitehouse Tony
- Wilcock Danielle
- Williams Abigail
- Williams Alexandra
- Willis Joan
- Wills Alasdair
- Wilson Matt
- Woods Lindsey
- Wright Stephen
- Yates David
- Yeung Joyce
- Zanoni Andrea
- Zolfaghari Parjam
- Zou Maggie
- Zungu Thembinkosi
- Zwiggelaar Kimberley
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
Background: Respiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.
Methods: PRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP. The trial is registered with the ISRCTN registry, ISRCTN56012545.
Findings: Between Feb 8, 2016, and Nov 11, 2019, 4806 patients were randomly assigned (2405 to the CPAP group and 2401 to the usual care group), of whom 4793 were included in the primary analysis (2396 in the CPAP group and 2397 in the usual care group). 195 (8\ub71%) of 2396 patients in the CPAP group and 197 (8\ub72%) of 2397 patients in the usual care group met the composite primary outcome (adjusted odds ratio 1\ub701 [95% CI 0\ub781-1\ub724]; p=0\ub795). 200 (8\ub79%) of 2241 patients in the CPAP group had adverse events. The most common adverse events were claustrophobia (78 [3\ub75%] of 2241 patients), oronasal dryness (43 [1\ub79%]), excessive air leak (36 [1\ub76%]), vomiting (26 [1\ub72%]), and pain (24 [1\ub71%]). There were two serious adverse events: one patient had significant hearing loss and one patient had obstruction of their venous catheter caused by a CPAP hood, which resulted in transient haemodynamic instability.
Interpretation: In this large clinical effectiveness trial, CPAP did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery. Although CPAP has an important role in the treatment of respiratory failure after surgery, routine use of prophylactic post-operative CPAP is not recommended
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
- 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
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- Doherty Ronan J
- Dollie Qaasim
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- Dominguez Joaquina
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- Draganic Brian
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- Drane Andrew
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- Essam Ibrahim El Desouki Muhammad Ahmed Muhammad
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- Falato Armando
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- Figueiredo Ana Gabriela
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- Forero-Torres Alexander
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- Garden O James
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- Winter Des
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- Wogensen Fredrik
- Wondoh Paul M.
- Wong Florence
- Wong Hsu Ven
- Wong Jane J
- Wong Jeremy
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- Wong Sui-Weng
- Wong Tsz Lun Ernest
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- Wren Sherry
- Wuraola Funmilola
- Xanthopoulou Georgia
- Yabut Kenneth
- Yacoub Aseel
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- Yaghi Yasmine
- Yahia Mohamed Ali Mohamed
- Yakushkina Al'ona
- Yalçinkaya Ali
- Yang P Zichu
- Yanikoğlu Erkan
- Yanni Fady
- 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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- Younes Maha
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- Yozgatli Tahir Koray
- Yu Kristin
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- Yunes Asmaa
- 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
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
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- Fairfield Cameron J
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- Figueiredo Ana Gabriela
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- Foschi Diego
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- Wondoh Paul M.
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- Wong Jane J
- Wong Jeremy
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- Yakushkina Al'ona
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- Yanni Fady
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- Ye Geoffrey
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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
Prospective observational cohort study on grading the severity of postoperative complications in global surgery research
- Author
- Abayasinghe Chamika
- Abbas Muntadhar
- Abbott T. E. F.
- Abbott Tom
- Abdullah Noor Hairiza
- Abdur-Rahman Lukman
- Abeloos Jacques
- Abernethy Caroline
- Abidin Ucu Nurhadiat
- Abrunhosa Alexandra
- Absar Mohammed
- Adam Suwayba
- Adams George
- Adamson Michael
- Adekola Oyebola
- Adelaja Yemi
- Ademola Adeyinka
- Adenekan Anthony
- Adenike Odewabi
- Adeolu Augustine A
- Adetoye Adedapo
- Adewale Badru
- Adigun Tinuola
- Adolfsson Anne
- Aflori Laura
- Africander Cucu
- Afshari Arash
- Agarwal Vandana
- Agodirin Olayide
- Aguzzoli Crisitiano
- Ahmad Abdurrahman
- Ahmad Norfaizan
- Ahmad T.
- Ahmad Tahania
- Ahmad Yousra
- Ahmed Ahmed
- Ahmed Jamil
- Ahmed Tahania
- Ai Yanqiu
- Aignatoaie Mariana
- Aimoniotou-Georgiou Eleni
- Akanmu Olanrewaju
- Akerman Nik
- Akinwale Mukaila
- Al Amri Khalid
- Al Hussaini Sabah
- Al-Soudaine Yassr
- Aladin Hafiz
- Alagbe-Briggs Olubusola
- Albaj Safauldeensalem
- Alcock David
- Alcock Liam
- Aldecoa Cesar
- Aldecoa Cesar
- Aleixo Fábia Berganton
- Alexander Hazel
- Alexander Maini
- Alexander-Sefre Farhad
- Alherz Fadhel
- Ali Hani
- Ali Marlynn
- Ali Sarah
- Alias Abdul Hafiz
- Alias Anita
- Alias Raja Liza Raja
- Allen Samantha
- Allen Sara Jane
- Allison Joanna
- Alloj Chiara
- Allorto Nikki Leigh
- Allsop Joanne
- Almeida William
- Alonso Eduardo
- Alonso José Ignacio
- Alphonsus Christella
- Alvares Danielle
- Alves Maria Joao
- Amador Juan Carlos Bravo
- Ameer Yusuf
- Amendola Cristina Prata
- Ami Noam
- Amstrup-Hansen Louise
- Anagnou Athina
- Andersen Cheme
- Anderson Charlotte
- Anderson Colette
- Anderson Frank
- Anderson Philip
- Andreadaki Evangelia
- Andreou Alexandros
- Andreou Prematie
- Andrew Alyson
- Andrews Emma
- Angel Miguel Paludi
- Angermair Stefan
- Angus Kirsty
- Anillo Victor
- Anizi Mashel Al
- Antal Oana
- Antill Philip
- Antoniadou Eleni
- Apagaki Eymorfia
- Apostolou Konstantinos
- Applewhaite Christopher
- Applewhaite Christopher
- Aquino Laura Patricia González
- Ar Praburaj
- Araujo Daniela Marques
- Arawwawala Dilshan
- Ardern Diane
- Argue Ruth
- Aribawa Mahaalit Alit
- Arkalaki Eleni
- Armaganidis Apostolos
- Armstrong John
- Armstrong Richard
- Arnaoutoglou Christina
- Arnaoutoglou Elena
- Arnold Glenn
- Arrandale Lindsay
- Arrich James
- Arrigo Mario
- Arshad Homa
- Arshad Mohammed Asif
- Artiles Tania Socorro
- Arumugam Swarna
- Arustei Mirela
- Arvaniti Kostoula
- Arvaniti Kostoula
- Arya Aryabiantara
- Arya Shobhit
- Asimakos Andreas
- Aslam M
- Asudo Felicia
- Athanasakis Elias
- Atiku Mamuda
- Attrill Elizabeth
- Attwood Clare
- Auer Patrick
- Avidan Michael
- Avila Erendira Jocelin Dominguez
- Avis Joanne
- Awad Hadi
- Axioti Elena
- Azam Ummi Azmira Ahmad
- Azambuja Pedro
- Azevedo Caroline
- Aziz Faizal Zuhri
- Baas Peter
- Baghirzada Leyla
- Bai Hui-Ping
- Baillie Shelley
- Baines Duncan
- Baio Thalissa Hermínia
- Bairaktari Aggeliki
- Baker Gerard
- Baker Katie-Anne
- Baker Paul
- Balain Birender
- Balajonda Naraida
- Balanescu Andreea
- Balasubramaniam Madhu
- Baldisserotto Sérgio
- Baldwin Jacqueline
- Baldwin Matthew
- Balfoussia Danai
- Bali Christina
- Bandeira Maria Expedito
- Banerjee Robin
- Bankewitz Carla
- Banner-Goodspeed Valerie
- Bao Qi
- Barcraft-Barnes Helena
- Barneto Lisa
- Barnett Andrew
- Barraclough James
- Barras Jean-Pierre
- Barrett Stephen
- Barrett Wendy Joan
- Basanth Sujith
- Batchelor Nick
- Bateman Brian
- Bates Alexander
- Bates Sarah
- Batista Hugo Dias
- Bauchmuller Kris
- Bauer Marlene
- Baumgarten Georg
- Baxter Linden
- Beaton Ceri
- Beattie Scott
- Beattie Scott
- Beattie Scott
- Beavis Vanessa
- Beavis Vanessa
- Bechan Sudha
- Beer Johan
- Bejia Tarek
- Belciu Ioana
- Belda Margarita Tormo
- Bell Gillian
- Bell Rachel
- Bell Rachel
- Bell Stephanie
- Bellandi Mattia
- Bello Jibril
- Beloeil Helene
- Belskiy Vladislav
- Beltran Anna Valle
- Ben-Menachem Erez
- Benavent Pau
- Benevento Angelo
- Bengeri Sheshagiri
- Bennett Cambell
- Bennett Michael
- Bennett Rachael
- Bennett Victoria
- Bentley Conor
- Beretta Luigi
- Berg Andrew
- Berg Bianca
- Bergin Colin
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- Bernard Andre
- Bernard Andre
- Bernat Maria Jose
- Berntsen Emer
- Berntsen Emer
- Bertram Wendy
- Bester Delia
- Bester Marlet
- Bettega Fernanda
- Bettinelli Alessandra
- Bhardwaj Neeraj
- Bhatia Kailash
- Bhula Chettan
- Bi Yanbing
- Biais M.
- Biais Matthieu
- Biais Matthieu
- Biccard Bruce
- Biccard Bruce M
- Bidd Heena
- Bidd Heena
- Bidgoli Jawad
- Biffen Andrew
- Bignami Elena
- Bilolikar Anjali
- Birch Julie
- Bishop David Gray
- Biyase Thuli
- Bizios Christol
- Blackwell Clare
- Blackwood Douglas
- Blaj Mihaela
- Blakemore Stephen P
- Bland Martin
- Blunt Mark
- Blyth Katharine
- Bocchino Speranza
- Bodansky Daniella
- Bodger Phoebe
- Boer Christa
- Boer Hans Donald
- Boereboom Catherine
- Boggiano Victoria
- Bokkel-Andela Janneke
- Bolaji Benjamin
- Bolton David
- Boone Myles
- Boschi Luca
- Boshier Piers
- Botes Marisa
- Botis Ioannis
- Bottini Corrado
- Bottrill Fiona
- Bouchez Stefaan
- Boulton Kerenza
- Bouris Vasilios
- Bourner Lynsey
- Boutsikos Georgios
- Bouwman Arthur
- Bouwman Arthur
- Bowrey Sarah
- Boxall Leigh
- Boyd Christine
- Bradburn Mike
- Bradburn Mike
- Bradley Jacqueline
- Branagan Graham
- Branco Teresa
- Brand Bastiaan
- Brandsborg Birgitte
- Breitenstein Stefan
- Brennan Andrew
- Brennan Emma
- Brenner Laura
- Brincat Maximilian
- Briscoe Richard
- Bristogiannis Sotirios
- Brooke Jenny
- Brookes Jamie
- Brookes Morag
- Brooks Carolyn
- Broomby Rupert
- Brotto Ana Flavia
- Brown Andrew
- Brown Caroline Wrey
- Brown Gemma
- Brown Jamie
- Brown Janette
- Brown Lynne
- Brown Richard
- Brown Robyn
- Browning Julie
- Bruma Dana
- Brunete Tamara
- Brunswicker Annemarie
- Bryant Helen
- Bua Emmanuel
- Buccimazza Ines
- Buckley Sarah
- Buerkle Christian
- Buhre Wolfgang
- Buhre Wolfgang
- Builu Pierre Monji
- Buise Marc
- Bullock Clare
- Bunwarie Bimalshakth
- Burns Karen
- Burrows Lorna
- Burrows Tom
- Burston Ben
- Burtenshaw Andrew
- Burton Megan
- Busuioc Mihai
- Butryn Izabella
- Butt Georgina
- Byrne Kelly
- Bührer Thomas
- Cabezuelo Estefania
- Cabral Raquel
- Cabrini Luca
- Cacala Sharon
- Cai Fang
- Cai Yunfei
- Cain Helen
- Cairns Carel
- Cakova Veronika
- Calderwood Claire
- Callaghan Mark
- Campbell Debbie
- Campbell Doug
- Campbell Doug
- Campbell Douglas
- Campbell Gill
- Campbell Graham
- Campbell Kathleen
- Campbell Marta
- Campbell Tara
- Campey Lorraine
- Campos Ferreira Mariana Fosch
- Camsooksai Julie
- Cancho David
- Candido Keulle
- Cang Jing
- Cannavo Maurizio
- Cao Jianqiao
- Cao Ying
- Cao Zhongming
- Cardellino Silvano
- Cardosa Jorge
- Cardoso Gutemberg
- Cardy Jon
- Carmino Livio
- Carp Cristina Paula
- Carr Adrienne
- Carrera Ronald
- Carroll Christine
- Carroll Jo
- Caser Eliana
- Castaño Beatriz
- Castle Gail
- Castro Gabriel Isaac Pereira
- Cavanagh Sarah
- Cawthorn Louise
- Cernea Daniela Denisa
- Chaddock Mark
- Chaloulis Panagiotis
- Chan Alexander
- Chan Hey Man Heymans
- Chan Mathew
- Chan Matthew
- Chan Matthew
- Chan Peter
- Chan Vincent
- Chan Wai Kit Jacky
- Chan Weng Ken
- Chan Yik Lam
- Chande Shiv
- Chandler Ben
- Chandra Susilo
- Chandra Susilo
- Chandrasekharan Shardha
- Chang Yuan Hsuan
- Chaniotaki Fotini
- Charitos Efthimios
- Charlalampidoy Alexandra
- Charles Rob
- Chatterjee Devnandan
- Chatterjee Jayanta
- Chatzimichali Aikaterini
- Chau Simon
- Chazova Elena
- Cheah Clarissa
- Cheah Seleen
- Cheeseman Michelle
- Cheing Yushio
- Chen Chao
- Chen Chen
- Chen Feifei
- Chen Fumei
- Chen Hong
- Chen James
- Chen Junping
- Chen Lee-lynn
- Chen Lee-lynn
- Chen Linbi
- Chen Liyong
- Chen Pushan
- Chen Qiang
- Chen Rong
- Chen Shasha
- Chen Shiyu
- Chen Sijia
- Chen Yaqiu
- Chen Yijiao
- Chen Yijun
- Chen Yongjie
- Chen Zhang
- Cheng Baoli
- Cheng Ka Ho
- Cherian Ritchie
- Cherrett Veronica
- Chetty Rubendraj R
- Chew Michelle
- Chew Michelle
- Chhabra Ashok
- Chicken Dennis-Wayne
- Chilinciuc Ion
- Chin Im Im
- Chirkut Subash
- Chlorou Dimitra
- Choi Hyun-min David
- Choi Stephen
- Chow Lorraine
- Christian Rachel
- Christiansen Ida Cecilie
- Christmas Natasha
- Christodoulidis Gregory
- Christodoulopoulou Theodora
- Christofaki Maria
- Christoforidis Dimitri
- Chronis Christos
- Chu Hiu Man
- Chu Susanna
- Chua Pandora
- Chukkambotla Srikanth
- Chung Chun Kwong Eric
- Cifra Elna
- Ciobanu Cristina
- Ciobotaru Oana Roxana
- Cirstea Emanuel
- Clark Richard
- Clarkson Aisling
- Clavien Pierre-Alain
- Claxton Andrew
- Clemmons Karen
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- Moodley Manogaran S
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- Zhou Jiali
- Zhou Jialong
- Zhou Jing
- Zhou Xian-jin
- Zhu Xiaomao
- Zhu Yi
- Zhu Zhipeng
- Zhuang Xiuxiu
- Zilis Georgios
- Zin Nor Hafizah Mohd
- Zingerle Nicolette
- Zingg Urs
- Zoerner Frank
- Zonneveldt Harry
- Zou Xiaohua
- Zoulamoglou Menelaos
- Zsisku Lajos
- Zundert Tom
- Zyl Rebekka
- åkring Irene
- Ögren Katrin
- Publication venue
- 'Wiley'
- Publication date
- 22/10/2018
- Field of study
Background
The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs).
Methods
This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs.
Results
A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59).
Conclusion
Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally
The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis
- Author
- Ab Majid Mohd Azuan
- Ab Rahman Ahmad Sufian
- Ab Rahman Rusnah
- Abayasinghe Chamika
- Abbas Muntadhar
- Abbott T. E. F.
- Abbott Tom
- Abd Ghafar Fara Nur Idayu
- Abd Hadi Husni Zaeem
- Abdel Goad Ehab Helmy
- Abdullah Noor Hairiza
- Abdur-Rahman Lukman
- Abeloos Jacques
- Abernethy Caroline
- Abidin Ucu Nurhadiat
- Abrunhosa Alexandra
- Absar Mohammed
- Adam Suwayba
- Adams David
- Adams George
- Adamson Michael
- Adekola Oyebola
- Adelaja Yemi
- Ademola Adeyinka
- Adenekan Anthony
- Adenike Odewabi
- Adeolu Augustine A.
- Adetoye Adedapo
- Adewale Badru
- Adigun Tinuola
- Adolfsson Anne
- Africander Cucu
- Afshari Arash
- Agarwal Vandana
- Agodirin Olayide
- Aguzzoli Crisitiano
- Ahamed khader null
- Ahmad Azam Ummi Azmira
- Ahmad Abdurrahman
- Ahmad Norfaizan
- Ahmad T.
- Ahmad Tahania
- Ahmad Yousra
- Ahmed Ahmed
- Ahmed Jamil
- Ahmed Tahania
- Ai Yanqiu
- Aignatoaie Mariana
- Aimoniotou-Georgiou Eleni
- Akanmu Olanrewaju
- Akerman Nik
- Akinwale Mukaila
- Al Anizi Mashel
- Al hussaini Sabah
- Al'Amri Khalid
- Al-Soudaine Yassr
- Aladin Hafiz
- Alagbe-Briggs Olubusola
- Albaj Safauldeensalem
- Alberto Lisi Zaheer Moolla
- AlbertoVolta Carlo
- Alcock David
- Alcock Liam
- Aldecoa Cesar
- Aleixo Fábia Berganton
- Alexander Hazel
- Alexander Maini
- Alexander-Sefre Farhad
- Alherz Fadhel
- Ali Hani
- Ali Marlynn
- Ali Sarah
- Alias Abdul Hafiz
- Alias Anita
- Alit Mahaalit Aribawa
- Allen Samantha
- Allen Sara Jane
- Allison Joanna
- Alloj Chiara
- Allorto Nikki Leigh
- Allsop Joanne
- Almeida William
- Alonso Eduardo
- Alonso José Ignacio
- Alphonsus Christella
- Alvares Danielle
- Alves Maria Joao
- Amador Juan Carlos Bravo
- Ameer Yusuf
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- Anillo Victor
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- Antill Philip
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- Applewhaite Christopher
- Aquino Laura Patricia González
- Ar Praburaj
- Arawwawala Dilshan
- Ardern Diane
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- Arkalaki Eleni
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- Arrigo Mario
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- Arshad Mohammed Asif
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- Arumugam Swarna
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- Arya Shobhit
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- Aslam F Noorbhai M.
- Asudo Felicia
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- Auer Patrick
- Avidan Michael
- Avila Erendira Jocelin Dominguez
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- Awad Hadi
- Axioti Elena
- Azambuja Pedro
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- Baldwin Matthew
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- Banerjee Robin
- Bankewitz Carla
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- Bao Qi
- Barcraft-Barnes Helena
- Barneto Lisa
- Barnett Andrew
- Baroselli Antonio
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- Biccard Bruce
- Biccard Bruce M.
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- Bouwman Arthur
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- Bradley Jacqueline
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- Buckley Sarah
- Buerkle Christian
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- Builu Pierre Monji
- Buise Marc
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- Chetty Rubendraj R.
- Chew M. S.
- Chew Michelle
- Chhabra Ashok
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- Chin Im Im
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- Chlorou Dimitra
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- Christiansen Ida Cecilie
- Christmas Natasha
- Christodoulidis Gregory
- Christodoulopoulou Theodora
- Christofaki Maria
- Christoforidis Dimitri
- Chronis Christos
- Chu Hiu Man
- Chu Susanna
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- Chung Chun Kwong Eric
- Cifra Elna
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- Ciobotaru Oana Roxana
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- Hu Chun hua
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- Zhao Weilu
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- Zheng Kang
- Zheng Lina
- Zheng Tianzhao
- Zhong Yi
- Zhou Ce
- Zhou Dachun
- Zhou Haidong
- Zhou Haiyan
- Zhou Jiali
- Zhou Jialong
- Zhou Jing
- Zhou Xian-jin
- Zhu Xiaomao
- Zhu Xiaoping
- Zhu Yi
- Zhu Zhipeng
- Zhuang Xiuxiu
- Zilis Georgios
- Zingerle Nicolette
- Zingg Urs
- Zoerner Frank
- Zonneveldt Harry
- Zou Xiaohua
- Zoulamoglou Menelaos
- Zsisku Lajos
- Åkring Irene
- Ögren Katrin
- Publication venue
- Health Sciences Research Commons
- Publication date
- 30/10/2017
- Field of study
© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine