4 research outputs found
A New Human Rights Court for West Africa: The ECOWAS Community Court of Justice
- Author
- Afolabi V Nigeria
- Afr J Int&apos
- Akinrinsola
- Alexandra Huneeus
- Anene
- Anene
- Anselm Chidi
- Arthur
- Bassey Udo
- Beth See
- Cep Final
- Crusoe Osagie
- De B�rca
- Durbin
- E G
- E G
- E G
- E G
- E G
- E G
- E G
- E G
- E G
- E G
- E G
- E G Ct Cmty
- E G See
- E G See
- E G U S
- E G Viljoen
- Ebobrah
- Ebobrah
- Ecw/Ccj/App
- Enabulele
- Erika De
- Eyo Charles
- Frans Viljoen
- Garba V Benin
- Gathii
- Gerald L Neuman
- Habr� V Senegal
- Habr� V Senegal
- Hassan V Nigeria
- Helen Duffy
- Henry Onoria
- Horace Adjolohoun
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Iheanacho Nwosu
- Institutional Kufuor
- Institutional Kufuor
- Ise-Olu-Oluwa Ige
- Jacqueline McAllister
- Judith G Bradley
- Karen J. Alter
- Keita V. Mali
- Laurence R Helfer
- Laurence R Helfer
- Laurence R. Helfer
- Lillian Okenwa
- Linda Akrasi Kotey
- Mali
- Manneh V. The
- Nwogu
- Okenwa
- Paul Pierson
- R Laurence
- Saidykhan
- Saidykhan
- Saidykhan
- Saidykhan
- Saidykhan V
- Sangeeta Shah
- See Ebobrah
- See Solomon
- Social Barrington Moore
- Specifically
- Supra Kabia
- Supranationality Sovereignty
- T Solomon
- The Alter
- The Kofi Oteng Kufuor
- Theda Skocpol
- Thelen Streeck
- Tony Anene-Maidoh
- U
- Wolfgang Streeck
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2013
- Field of study
Revisiting the Economic Community of West African States: A Socio-Legal Analysis
- Author
- ---
- ---
- ---
- ---
- ---
- ---
- . L Vill
- _____________
- A Acharya
- A O Enabulele
- A Yansane
- Ablam Akoutou
- Aboubakar Diaby-Ouattara
- Adebayo Adedeji
- Adebayo Olukoshi
- Adekeye Adebajo
- Aderanti Adepoju
- Alassane D Ouattara
- Alexander Lee
- Amadu Sesay
- Amadu Sesay
- Amanda Perry-Kessaris
- Andreas Von Staden
- Andr� Mangu
- Anthony Vanduzer
- Anuke Ovrawah
- Arturo Escobar
- Bankole Thompson
- Bj�rn Beckman
- Bj�rn Hettne
- Brian H Bix
- Brian Tamanaha
- Brian Tamanaha
- Brian Tamanaha
- Brian Z Tamanaha
- Business Times Nigeria
- C Breslin
- C Cownie
- C Daniel
- Carol Lancaster
- Celine Tan
- Celine Tan
- Chalmers Johnson
- Chimelu Chime
- Christopher Clapham
- Christopher Griffin
- Christopher Lord
- Christopher Tuck
- Clair Gammage
- Clair Gammage
- Crawford Young
- Crawford Young
- D J Galligan
- D J See
- Daily Post
- Daniel C Bach
- Daniel Flemes
- Daniel Sakyi
- David Dollar
- David Kennedy
- David M Trubek
- David M Trubek
- David M Trubek
- David M Trubek
- Dermont Feenan
- Dirk Berg-Schlosser
- Dirk Kohnert
- Dirk Kohnert
- Douglas Litowitz
- Douglass C North
- Douglass C North
- Dr Gilles Yabi
- Dr H�nggi
- Duncan Kennedy
- Ecowas Parliament
- Ecw/Ccj/Jud
- Elisa Tino
- Emmanuel Anang
- Emmanuel Fanta
- Emmanuel Obuah
- Enyinna S Nwauche
- Eric M Edi
- Ernst B Haas
- Ernst Haas
- Franz Heidhues
- Frederick Cooper
- Frederick Cooper
- Frederik S�derbaum
- Fredrik ____________
- Fredrik S�derbaum
- Fredrik S�derbaum
- G A Obiozor
- Gabriel Mougani
- Gabriel See
- Gathii
- Gathii
- General Gowon
- Geoffrey M Hodgson
- Gerald Ajumbo
- Gerhard Erasmus
- Gilman
- Graham Mayeda
- Grant J Andrew
- H Prempeh
- Hadijatou&apos
- Hans-Otto Sano
- Hartman Christof
- Helen Duffy
- Helen Duffy
- Henry Onoria
- Heribert Dieter
- Horace S Adjolohoun
- Horacio A Naon
- Ian Taylor
- Ibid
- Ibid
- Ibrahim Gambari
- Iheduru
- Iwa Akinrinsola
- Iwa Salami
- J
- J Andrew Shaw
- J C Aghaji
- J K Nyerere
- J Riddell
- Jakob Engel
- James Gathii
- James Gathii
- James Meernik
- James T Gathii
- Jean Allain
- Jean Aspremont
- Jean-Francois Bayart
- Jeremy Levitt
- Jeremy Levitt
- Jerry Ukaigwe
- Jodie Keane
- John Anarfi
- John H Jackson
- John N Drobak
- John W Sloan
- Jose E Alvarez
- Joseph Nye
- Joseph Nye
- Joseph Richard
- Joshua Meltzer
- Julius K Nyerere
- Julius Okolo
- Jurgen Ruland
- K Meagher
- Karen Alter
- Karen J Alter
- Kate Meagher
- Kerry Rittich
- Klaus Dingwerth
- Kofi Kufuor
- Kofi Kufuor
- Krapohl
- L Fawcett
- Laurence R Helfer
- Linda Bore
- Lloyd Gruber
- M David
- M Ewing-Chow
- M Granovetter
- M Granovetter
- M Hirsch
- M Lee
- M Millerman
- M&apos
- Malcolm M Feeley
- Mamadou Diallo
- Mamit Deme
- Manfred Bienefeld
- Marian Ansah
- Martin Hopner
- Martti Koskenniemi
- Mathew Doidge
- Maxwell O Chibundu
- Maxwell O Chibundu
- Merran Hulse
- Merran Hulse
- Mia Swart
- Mohammed Bedjaoui
- Morten B��s
- Musa Saidykhan V. Republic
- Mwita Chacha
- N Annan
- Nic Cheeseman
- Nils Gilman
- O Nnenna
- Obiora Okafor
- Olabisi D Akinkugbe
- Olabisi D. Akinkugbe
- Olatunde J Ojo
- Olawale E Ogunkola
- Old Early
- Oli Brown
- Oliver E Williamson
- Omano Edigheji
- P Carmody
- P Cerny
- P Cerny
- P Schouten
- Pacifique Manirakiza
- Paul D Williams
- Paul Nantulya
- Percy S Mistry
- Peter Draper
- Peter Nedergaard
- Peter Robson
- R Sweberg
- Radha D&apos
- Raimo Vayrynen
- Rasul Shams
- Raymond A Atugbua
- Richard F Oppong
- Richard See
- Rita Abrahamsen
- Rita Abrahamsen
- Rita Abrahamsen
- Robert E Hudec
- Robert Lee
- Roger Cotterrell
- Roger Cotterrell
- S K Asante
- S K B Asante
- S K B Asante
- S Shagari
- Sa
- Sabine Frerichs
- Samuel Moyn
- Samuel Oloruntoba
- Samuel Oloruntoba
- Schouten
- See Andr� Mbata Mangu
- See Dirk Kohnert
- See Generally Jean Allain
- See Global Network
- See Karen
- See Kufuor
- See Okechukwu
- See Pacifique Manirakiza
- See Robert Lee
- See Sebastian Krapohl
- See Shaw
- See The Citizen
- Shaun Breslin
- Shehu Shagari
- Sheila Page
- Silke Trommer
- Solomon T Ebobrah
- Solomon T See
- Stephen Brown
- Stephen Brown
- Stephen S Golub
- Sunday Ajulo
- T Mkandawire
- Tanja A B�rzel
- Tanja A B�rzel
- Terry Flew
- Thomas Jaye
- Tidjani V Nigeria
- Timothy M Shaw
- Tiyanjana Maluwa
- Toyin Falola
- Ufiem Ogbonnaya
- Umut �zsu
- V Chambers
- West Gowon
- Wilfred J Ethier
- William Easterly
- William Ropke
- Yash P Ghai
- Yinka Omorogbe
- Yongzheng Yang
- Ziya �ni?
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2017
- Field of study
The Principle of Democratic Teleology in International Law
- Author
- &
- &
- .
- A U Doc
- A U Doc
- A U Doc
- Abraham D Sofaer
- African
- Almond &
- Amaryllis See
- Amitav Acharya
- Andreas Paulus
- Anne Orford
- Anne Peters
- Antonio Cassese
- August�n Jos� Men�ndez
- Bbc News Online
- Byers &
- Byers &
- Byers &
- Byers &
- Byers &
- Christof Hartmann
- Cornell Int&apos
- Corten
- David S Berry
- De Wouters
- Dexter S Boniface
- Dino Kritsiotis
- Douglas Lee Donoho
- E G See
- Ecowas Treaty Of
- Enrique Lagos
- Escudero Espinosa
- F Lee
- Fernando R
- Fernando R Tes�n
- Franck
- G A Res
- G A Res
- Gabriel Abraham Almond &
- George President
- George W Bush
- H Gregory
- H Morton
- Ian Brownlie
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Id
- Inter-American Democratic
- James Crawford
- Jason Pedigo
- Jeremy Levitt
- Joakim �jendal
- John Quigley
- Julia Leininger
- Karsten Nowrot
- Kufuor Kofi Oteng
- Larry Diamond
- Law &
- Lillich
- Lipset
- Lord Goldsmith
- Louis E Fielding
- Louis Henkin
- Louise Doswald
- Marco Gestri
- Mary Ellen
- Mary Ellen
- Matthias Goldmann
- Mich J Int&apos
- Michael Bothe
- Michael Byers &
- Michael J Glennon
- Michele Wucker
- Myron Weiner
- Niels Petersen
- Niels Petersen
- O A S Doc
- O A S Doc
- O A U Doc
- Olivier Corten
- Oscar Schachter
- Oscar Schachter
- P Ved
- Paul D Williams
- R
- Renaud Dehousse
- Richard A Falk
- Richard B Lillich
- Robert D Putnam
- Robert F Turner
- Ronald St
- S C
- S C Res
- S C Res
- S C Res
- S C Res
- S C Res
- S C Res
- Sarah A Rumage
- Scott Davidson
- See Christina
- See Davis Brown
- See Enrique Lagos &
- See Hermann
- Sonia Picado
- Supra Blanke
- Supra Donoho
- Supra Hartmann
- Supra Roth
- Supra Roth
- Supra Tes�n
- Supra Tes�n
- Supra Tes�n
- Supra Tes�n
- Supra Tes�n
- Tiyanjana Maluwa
- U N Bardo Fassbender
- Valentina Grado
- William Michael Reisman
- William Michael Reisman
- William Michael Reisman
- Williams
- Yves Beigbeder
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2008
- Field of study
Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study
- Author
- Abada S
- Abbas Syed R
- Abbas JD
- Abdalla M
- Abdel-Khaleq S
- Abdelrahim ASA
- Abdelrazek M
- Abdelrazik Y
- Abdi M
- Abdolrazaghi S
- Abdul-Fattah S
- Abdulla S
- Abdullah M
- Abi Aoun R
- Abid S
- Abigail S
- Abou El Ela Bourquin B
- Abousamra M
- Adabavazeh B
- Adams J
- Adams M
- Adams N
- Adcock A
- Adebambo D
- Adeboyejo O
- Adeeko ES
- Adelekan K
- Adelowo T
- Adeniken E
- Adeoye A
- Adeusi L
- Afsheen N
- Agarwal A
- Agarwal G
- Agarwal N
- Agbinya N
- Aghanenu O
- Agiotakis S
- Aguirrezabala Armbruster B
- Ahari D
- Ahmad Fuad MF
- Ahmad MA
- Ahmad NA
- Ahmadi H
- Ahmed Osman A
- Ahmed A
- Ahmed I
- Ahmed J
- Ahmed M
- Ahmed O
- Ahmed S
- Ahmed SK
- Ahmed W
- Ainsworth J
- Ainsworth K
- Aitken S
- Ajdarpasic D
- Ajekigbe F
- Akbar Z
- Akhbari M
- Akintunde A
- Akinyemi J
- Akmal A
- Akmal K
- Akram B
- Al Bahri T
- Al Bakry M
- Al Dabbagh A
- Al Rawi M
- Al Sadek Y
- Al-Hamid Z
- Al-Khafaji M
- Alam F
- Alattas A
- Alawattegama LH
- Alberts J
- Alfadhel S
- Alhwaishel K
- Ali Butt S
- Ali A
- Ali K
- Ali M
- Ali N
- Ali S
- Alim L
- Alkandari B
- Alkoot M
- Allan D
- Allan J
- Allen K
- Allen R
- Allin D
- Almoosawy SA
- Alom J
- Alsaady A
- Alsadoun L
- Alsusa H
- Alves do Canto Brum H
- Alves D
- Aly R
- Alyacoubi S
- Amakye NY
- Amarnath T
- Amin A
- Amin M
- Amini B
- Anandampillai R
- Anarfi S
- Anderson E
- Anderson P
- Anderton J
- Andrew F
- Anjum Z
- Ansar Z
- Anthony Wilkinson J
- Antypas A
- Anuar A
- Apata A
- Appanna T
- Appleton B
- Appleyard T
- Arain Z
- Aranha M
- Arnold A
- Arnold C
- Arora E
- Arrayeh A
- Arshad M
- Arshad SR
- Arthur-Quarm S
- Arumugam V
- Arwi G
- Ashai S
- Asharaf H
- Ashaye A
- Ashcroft-Quinn S
- Ashdown T
- Ashman M
- Ashok A
- Ashwell W
- Ashworth I
- Asif A
- Asvandi S
- Atherton R
- Atiyah A
- Atkins W
- Aung E
- Aung YY
- Austin T
- Ayandokun P
- Ayub H
- Azam R
- Azam Z
- Azeez Z
- Azizan N
- Azizi S
- Azlan A
- Azouaghe O
- Bachelet B
- Bacigalupo V
- Bacon H
- Badminton R
- Badran A
- Bahl S
- Bailey A
- Bain J
- Bajaj M
- Bajaj S
- Bajaj V
- Baker C
- Baker D
- Baker J
- Baker O
- Bakina C
- Balakumar V
- Balasubramanian A
- Balasubramanian N
- Bald A
- Balfour J
- Ball M
- Bandyopadhyay D
- Bandyopadhyay S
- Bangi S
- Bani W
- Bannister J
- Barabas M
- Baraza W
- Barciela C
- Bardon A
- Barham E
- Barnes R
- Barrett G
- Barrington J
- Barrington M
- Barry I
- Barry J
- Barry K
- Bartlett M
- Barton O
- Bashiti H
- Basi S
- Baskaran R
- Bassett E
- Batchelor C
- Batchelor-Parry H
- Bawa G
- Bawa JH
- Beattie M
- Beck C
- Bee F
- Beg R
- Belais F
- Belk LH
- Bellam S
- Ben-Arzi H
- Bennett T
- Bennewith R
- Berry A
- Bettoli G
- Bevis R
- Bhachoo H
- Bhadra K
- Bhandari A
- Bhangu A
- Bhardwaj R
- Bharwada Y
- Bhat A
- Bhate R
- Bhatia P
- Bhatia S
- Bhattarai S
- Bhatti M
- Bhatti S
- Bhavra K
- Bhoombla N
- Bhudia R
- Bhullar D
- Bibi F
- Biddles D
- Bilal A
- Billson E
- Bilolikar A
- Bird R
- Birnie C
- Bishop A
- Bisson E
- Bix E
- Bloom I
- Blott N
- Boaden L
- Boggon E
- Bogie E
- Bojanic C
- Bommireddy L
- Bonte A
- Borakati A
- Bosley N
- Botsa E
- Bottomley J
- Bourke E
- Bourne K
- Bowen K
- Bowes A
- Bowley D
- Boyle C
- Bradley J
- Bradshaw E
- Brady R
- Braganza J
- Bratsos S
- Brazier B
- Brazkiewicz M
- Breathnach C
- Brenac S
- Brew A
- Bridges I
- Broad G
- Broekhuizen A
- Brookes T
- Brothwood D
- Brousse de Gersigny J
- Browlee O
- Brown A
- Brown C
- Brown E
- Brown G
- Brown L
- Brown R
- Brown S
- Browne R
- Bruce D
- Bryan A
- Bryans K
- Bucknall T
- Budd W
- Budding J
- Bunni J
- Burke D
- Burns F
- Burns J
- Burrell K
- Burt G
- Burt J
- Burtle D
- Burton L
- Burton M
- Burway S
- Buxton-Hopley R
- Byrne M
- Cahya E
- Caldwell S
- Cambridge WA
- Cameron F
- Campbell A
- Campbell B
- Cann J
- Carberry E
- Carey C
- Carpenter H
- Carr W
- Carrick M
- Carroll L
- Carroll M
- Casey A
- Cavanagh S
- Chadda KR
- Chadwick T
- Chalkley M
- Chamberlain G
- Champion A
- Chan C
- Chan LH
- Chan SMZ
- Chan XHF
- Chand CP
- Chandegra A
- Chander B
- Chandrasekaran J
- Chandratreya N
- Chang C
- Chaora T
- Chapman D
- Chapman S
- Chapman T
- Chapple K
- Charalambous M
- Chatha S
- Chau CYC
- Chaudhari S
- Chawla S
- Cheah E
- Chee J
- Cheekoty P
- Cheema J
- Chellapuri A
- Chen JY
- Cheng T
- Chennupati R
- Cheong J
- Cherry C
- Cheung A
- Cheung J
- Chew D
- Chew SJHL
- Chia D
- Chia WL
- Chikomba L
- Chinta SH
- Chiong J
- Chittoor Satish NN
- Chiu C
- Chlubek M
- Chmielewski G
- Cho SH
- Choa G
- Choi NY
- Chong A
- Chong C
- Chong T
- Chong V
- Choo LY
- Choo SY
- Chopra P
- Chou WK
- Choudhry A
- Choudhry H
- Chow J
- Chow R
- Chow YW
- Chowdhury A
- Chowdhury S
- Chowdhury T
- Chrisp B
- Christie I
- Christou A
- Chu J
- Chu K
- Chu TSM
- Chu YYA
- Chung I
- Chung S
- Cinnamond A
- Cirelli C
- Clark A
- Clark F
- Clark G
- Clark L
- Clarke G
- Clayton B
- Clayton S
- Cleaver J
- Clement NS
- Clements B
- Clements JM
- Cloney M
- Coates S
- Cockroft A
- Coldwell C
- Coleman O
- Coleman S
- Colman J
- Colterjohn N
- Common J
- Common T
- Compton M
- Connachan R
- Connell B
- Constantinides M
- Conti I
- Cook A
- Cook E
- Cookey-Bresi R
- Coombe-Jones M
- Coombs A
- Cooper Drake B
- Cooper L
- Cope P
- Cope S
- Copeland L
- Cornwall H
- Corrin E
- Costa I
- Coulson A
- Coulthurst J
- Court EL
- Covell G
- Coyle J
- Creagh-Brown B
- Creissen A
- Cresswell B
- Cripps P
- Crisp E
- Crook D
- Crosbie S
- Croyle JA
- Cullen G
- Cullimore V
- Cummings D
- Cummins T
- Cundy A
- Curran E
- Curran S
- Curtis Lopez C
- Cuthbert H
- D Portela S
- D'Afflitto M
- D'Cunha Kamath A
- Dadnam F
- Dale VH
- Daniel S
- Daniell A
- Daniels M
- Dar T
- Darkwa S
- Darling H
- Datta A
- Dattani A
- Dauncey J
- Davies C
- Davies E
- Davies G
- Davies L
- Davies P
- Davies R
- Davies-kelly N
- Davis L
- Davis P
- Dawas K
- Dawson A
- De Andres Crespo M
- De Berker H
- De Carvalho L
- De Kock Jewell V
- De Soysa S
- Deans J
- Deekonda P
- Deliyannis E
- Deng A
- Dermanis A
- Desai B
- Desai N
- Deshpande A
- Devalia K
- Devi S
- Devindaran A
- Devine A
- Dexter E
- Dhar M
- Dhebri A
- Dhuga Y
- Di Traglia R
- Dickinson M
- Dickinson S
- Dilaver N
- Dinesh AA
- Dinh TH
- Dixit A
- Dixon C
- Dixon M
- Dixon Y
- Do Le HP
- Do JE
- Dobinson C
- Dodhia V
- Doherty C
- Doherty W
- Dominguez E
- Donnelly A
- Donnelly B
- Donnelly HA
- Donohue J
- Doré C
- Down B
- Doyle C
- Drake I
- Drake J
- Drew W
- Drusch B
- Dudi-Venkata NN
- Duller A
- Duque Golding J
- Durand M
- Dwaraknath M
- Eagles EJ
- Eardley N
- Easby S
- Edelsten E
- Edwards J
- Edwards M
- Edwards P
- Egoroff N
- Eichenauer CE
- Ekpete O
- El Sabawy D
- El Sheikh M
- Elawad A
- Eldridge M
- Eleni A
- Elhakim H
- Elkawafi M
- Elliott J
- Elliott JA
- Elliott M
- Ellis J
- Elmansouri A
- Elsayeh K
- Elsharkawi A
- Elzanati H
- Emmanuel T
- Emms L
- English C
- Enver M
- Epanomeritakis E
- Eriksson F
- Erotocritou M
- Evans A
- Evans B
- Evans C
- Evans E
- Evans L
- Evans N
- Ezennia K
- Fabelurin C
- Fairclough S
- Fairey M
- Faisal H
- Fan J
- Fang B
- Farah Y
- Farbood K
- Faris Mahmood H
- Farr E
- Farrelly C
- Farrugia A
- Fatimah Hussain Q
- Faulkner G
- Fawdon R
- Fay E
- Fearnhead N
- Feather A
- Fegredo D
- Feighery A
- Felstead D
- Fenton J
- Ferarrio I
- Fernando D
- Fernando P
- Ferriman A
- Ferrin S
- Feyi-Waboso J
- Field C
- Field D
- Figg K
- Finch G
- Findlay J
- Fischer F
- Fish J
- Fisher K
- Fisher T
- Fitzgerald C
- Flach A
- Flint J
- Fludder V
- Ford C
- Forenc K
- Forrest M
- Fort-Schaale A
- Fortescue L
- Foster K
- Foster-Davies H
- Foulkes A
- Fowler G
- Fox C
- Fox S
- Francis D
- Francis N
- Franco Da Silva C
- Francombe J
- Franklin S
- Franklyn J
- French B
- French N
- French R
- Frisira E
- Fu YXJ
- Fung E
- Fung HKF
- Fung YJ
- Furlepa M
- Gaba F
- Gabrel M
- Gallagher C
- Gallagher H
- Gallie R
- Galvin C
- Gamage K
- Ganapathy M
- Gandhi P
- Gandhi T
- Ganewatta Kankanamge D
- Gardener M
- Gardiner H
- Gardner M
- Garg J
- Garg S
- Gargan K
- Garland H
- Garner J
- Garwood P
- Gaston-Grubb M
- Gatumbu P
- Gaunt E
- George HA
- George S
- Georgi T
- Gercek Y
- Germani Batacchi M
- Ghazal R
- Ghose R
- Ghosh I
- Giang S
- Gibbins A
- Gibbons H
- Gibson C
- Gill D
- Gill M
- Gill N
- Gill P
- Gillespie R
- Gilliam A
- Girdlestone H
- Girish M
- Glasbey JC
- Glasson R
- Glen P
- Glover T
- Goan R
- Godhaniya J
- Goede A
- Gogna A
- Goh J
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- Venkatesh A
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- Woodward S
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- Woon-Shoo-Tong XS
- Worthington J
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- Xu S
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- Yunus A
- Yusufi U
- Zachariah M
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- Zaheer M
- Zahid M
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- Zalmay P
- Zaman M
- Zaman S
- Zander A
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- Zeng G
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- Zhao S
- Zhao Z
- Zhu L
- Zilber E
- Zimmerman M
- Zuhairy S
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/06/2022
- Field of study
Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society