18 research outputs found
Deflection of Laminated Composite Plates Using Dynamic Relaxation Method
- Author
- Publication venue
- ScienceScholar
- Publication date
- 01/04/2017
- Field of study
First – order orthotropic shear deformation equations for the nonlinearly elastic bending response of rectangular plates are introduced. Their solution using a computer program based on finite differences implementation of the Dynamic Relaxation (DR) method is outlined. The convergence and accuracy of the DR solutions for elastic large deflection response of isotropic, orthotropic, and laminated plates are established by comparison with various exact and approximate solutions. The present Dynamic Relaxation method (DR) coupled with finite differences method shows a fairly good agreement with other analytical and numerical methods used in the verification scheme. It was found that: The convergence and accuracy of the DR solution are dependent on several factors including boundary conditions, mesh size, and type, fictitious densities, damping coefficients, time increment and applied load. Also, the DR large deflection program using uniform finite differences meshes can be employed in the analysis of different thicknesses for isotropic, orthotropic, or laminated plates under uniform loads. All the comparison results for simply supported (SS4) edge conditions showed that deflection is almost dependent on the direction of the applied load or the arrangement of the layers
Validity of Finite Element Method: Analysis of Laminated Composite Decks Plates Subjected to in Plane Loading
- Publication venue
- Scientific and Literature Open Access Publishing
- Publication date
- 05/07/2019
- Field of study
To verify the accuracy of the present technique, buckling loads are evaluated and validated with other works available in the literature. Further comparisons were carried out and compared with the results obtained by the ANSYS package and experimental results. The good agreement with available data demonstrates the reliability of the finite element method used
Stability of Thin Laminated Decks Plates Under Plane Compressive Loading
- Publication venue
- Scientific and Literature Open Access Publishing
- Publication date
- 21/03/2019
- Field of study
It was found that symmetric laminates are stiffer than the anti – symmetric one due to coupling between bending and stretching which decreases the buckling loads of symmetric laminates. The buckling load increases with increasing aspect ratio, and decreases with increase in modulus ratio. The buckling load will remain the same even when the lamination order is reversed. The buckling load increases with the mode number but at different rates depending on the type of end support. It is also observed that as the mode number increases, the plate needs additional support
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A.
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
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- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
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- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
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- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
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- Ademuyiwa Adesoji O.
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- Aguilera Maria Lorena
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- Ahlonsou Germain
- Ahlqvist Sandra
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- Ahmed Asdaq
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- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- Elsevier
- Publication date
- 01/06/2003
- Field of study
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2022
- Field of study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
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- Wondoh Paul
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- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Mortality of emergency abdominal surgery in high-, middle- and low-income countries
- Author
- A A Ahmed Ata
- A A Ibrahem
- A A Maghrabi
- A A Nasir
- A A Ne'ma Abdullah
- A Abd El Galeel
- A Abdel-Rahman Al-Aarag
- A AbdelFattah
- A Abdelgelil
- A Abdelkareem
- A Abdelmotaleb Ghazy
- A Aber
- A Abo El Magd
- A Abo Elazayem
- A Aboarab
- A Abouelnasr
- A Abouzahra
- A Adebanjo
- A Adekoya
- A Adel
- A Adel
- A Ademuyiwa
- A Adeniyi
- A Adesina
- A Adesuyi
- A Adeyeye
- A Afandy
- A Agarwal
- A Ahmed
- A Al-Mallah
- A Al-Shammari
- A Aldalaq
- A Ali
- A Ali
- A Alkammash
- A Allegri
- A Almallah
- A Almoflihi
- A Alrifaie
- A Altaf
- A Altamimi
- A Althwainy
- A Arenas
- A Ashton
- A Atef Omar
- A Austraite
- A B Zerihun
- A Badr
- A Badwy
- A Baird
- A Bamicha
- A Benevento
- A Bhangu
- A Bhargava
- A Birring
- A Boddy
- A Bondurri
- A Bonnard
- A C Manchego Bautista
- A C Manchego Bautista
- A C Roslani
- A C Snaith
- A Cacurri
- A Chambers
- A Chambers
- A Chapman
- A Chowdhury
- A Chun
- A Daltri Lazzarini Cury
- A Daqeeq
- A Das
- A Diab
- A Driscoll
- A Dubois
- A Dwydar
- A E Ajao
- A E K Musa
- A E Ward
- A Echevarria Rosas Moran
- A El Gendy
- A El Kholy
- A Elbatahgy
- A Elgebaly
- A Elkelany
- A Elkelany
- A Elkelany
- A Elkelany
- A Elkholy
- A Elshafay
- A Elwaey
- A Elwan
- A Essam Elnemr
- A Eysa
- A F Palma
- A Fadel
- A Fahiem
- A Farah
- A Faraz
- A Farquharson
- A Faure
- A Fawzy
- A Fouad
- A G N Robertson
- A Gamal Toeema
- A Garland
- A Gerosa
- A Gharib
- A Gharib
- A Gheith
- A Gomaa
- A Gouda
- A Grant
- A Gudal
- A Habeebullah
- A Hafez El-Badri Kotb
- A Hagar
- A Hammad
- A Hanks
- A Haroun
- A Hasan
- A Hasheminia
- A Hashish
- A Hassan
- A Hassan
- A Hassan
- A Hegazy Khedr
- A Horobjowsky
- A Hussein
- A Huwait
- A J Fowler
- A Jabbar
- A Karim
- A Kenibar
- A Khairy Aly
- A Khalique
- A Khan
- A Khoja
- A Khyrallh
- A Kiasat
- A Kirishnan
- A Kirupagaran
- A Kjellin
- A Kolosov
- A Kyaw Tun
- A L Contreras Vergara
- A L Mclean
- A Lasheen
- A Leal
- A Leppäniemi
- A Livesey
- A M Afifi
- A M Altwigry
- A M Attia
- A M Elkorashy
- A M Hammad
- A M Mphatsoe
- A M Saeed
- A M Shariffuddin
- A M Warwick
- A Macdonald
- A Macfarlane
- A Maffioli
- A Mahdi
- A Maniscalco
- A Marey
- A Martin
- A Mcguigan
- A Mcphee
- A Menshawy
- A Minocha
- A Mirza
- A Mistry
- A Mittal
- A Mohameden
- A Mohammad
- A Mohammed
- A Mohammed
- A Mokhtar
- A Morsi
- A Mosad
- A Munera
- A Nabawi
- A Nashaat
- A Nasr
- A Nawawi
- A Negida
- A Nesaratnam
- A Niragire
- A Nocito
- A Novak
- A Ogunyemi
- A Oluwagbemiga Lawal
- A Oosterkamp
- A Osama Elsebaaye
- A Osinowo
- A Osman Abdelaziz Elhendawy
- A P Arnaud
- A Popoola
- A Powell
- A Prabhudesai
- A R Mitul
- A Ragab Nayel
- A Ragab Soliman
- A Ramadan
- A Ramos-De La Medina
- A Rasendran
- A Rasendran
- A Rasendran
- A Rashid
- A Raslan
- A Riaz
- A Rotundo
- A Rslan
- A Rudzenskaite
- A S Mironescu
- A S North
- A Sabry
- A Sabry El-Hamouly
- A Sadek
- A Safwan Marey
- A Sakr
- A Salah Elsherbiny
- A Salleh
- A Samir
- A Sanad
- A Sayed
- A Scalabre
- A Shabkah
- A Shah
- A Shalaby
- A Sheshe
- A Skardžiukaitė
- A Solaiman El-Ma'doul
- A Spina
- A Sreedharan
- A Sriram
- A Stephen
- A Strazdas
- A Szczap
- A Tade
- A Tammam
- A Tanase
- A Tanase
- A Tang
- A Tarek
- A Tarek Hafez
- A Thorell
- A Usaityte
- A Vega Carreiro De Freitas
- A Venâncio De Sousa
- A Vlachogiorgos
- A W Anwar
- A Watts
- A Williamson
- A Wilson
- A Zani
- A Zardab
- A Zeynel A Balkan
- A Zil-E-Ali
- Abid Bin Mahamood
- B Albeladi
- B Alghamdi
- B B Ozkan
- B B Ozkan
- B Cameron
- B F Hon Khi Chong
- B Frisk
- B Magdy
- B Mansour
- B Mijuskovic
- B Nighat
- B Odeyemi
- B Pereira
- B Pereira Silvestre
- B S Kumar
- B Sieda
- B Skelly
- B Thompson
- B Van Duren
- B Weber
- B Wolf
- B-V Martian
- C A Arroyo Basto
- C A Azmitia Mendizabal
- C Agalianos
- C Anthoulakis
- C Beaton
- C Bode
- C Boereboom
- C Bowman
- C C Goh
- C C L Szeto
- C C Ramã Rez Cabrera
- C Ceriani
- C Chandrakumar
- C Clifford
- C Currow
- C Dervenis
- C Diaz-Zorrilla
- C E Lopez
- C Fahy
- C Fairfield
- C Fairfield
- C Fermani
- C Gouldthorpe
- C Grossart
- C Hand
- C Hinojosa
- C Houlden
- C I Pérez Velásquez
- C J Mcintyre
- C Jenvey
- C Jones
- C Khatri
- C Koh
- C Lee
- C Leung Chong
- C Leung Chong
- C Leung Chong
- C Lopez-Arevalo
- C López
- C M Rees
- C Magee
- C Mangan
- C Mangan
- C Marinos
- C Mason
- C Milagros Herrera Puma
- C Morales
- C Morgan
- C Muller
- C Nawara
- C Neophytou
- C Normile
- C Normile
- C Nwokoro
- C Oliveira Felipe
- C Ou Yong
- C P García Torres
- C P Major
- C Raslan
- C S Wong
- C Sampson
- C Schoewe
- C Smith
- C Tedjaatmadja
- C Tolg
- C Venugopal
- C Vinícius Barroso de Lima
- C W Ho
- C Wredberg
- C Y Chen
- C Y Tan
- D A Amin Elsorogy
- D A Raptis
- D A Romani Pozo
- D A Soeselo
- D Alkhabbaz
- D Anandkumar
- D Anderson
- D Bowley
- D Brown
- D C Marshall
- D Dabessa
- D Donoghue
- D Du Plessis
- D Duarte Cadogan
- D E Marroquín Rodríguez
- D Emadeldin
- D Fouad
- D Golding
- D Heffernan
- D Hemeda
- D Hemingway
- D I Samaraweera
- D Iyer
- D J Clark
- D Karousos
- D Kazanavicius
- D Kotecha
- D L Deckelbaum
- D Loughran
- D Lytras
- D M Cocker
- D M Elbendary Elsawahly
- D Mapasse
- D McCullagh
- D Mckechnie
- D McMorran
- D Mcnish
- D Merlini
- D Mirghani
- D Nel
- D Pata
- D Periasammy
- D R L Browning
- D Roi
- D Samuel
- D Schivo
- D Smith
- D Stewart
- D Venskutonis
- D Venskutonis
- D Vimalachandran
- D Vinicius Dos Santos
- D Youssef
- D Öfner
- D-C Zachariades
- E Abdallah
- E Abington
- E Adel Sayma
- E Ali Ahmed
- E Aljohani
- E Aljohani
- E Alnawam
- E Alqahtani
- E Barrios
- E Barrios
- E Blower
- E Borg
- E Borin
- E Brown
- E Chan
- E Court
- E D Kennedy
- E Decker
- E Dempster
- E Domini
- E E Howie
- E Elbanby
- E Etchill
- E Eyssartier
- E F Zimmermann
- E Farinella
- E G Escobar
- E G Heywood
- E Gaignard
- E Gaignard
- E Gamaly
- E Ghanem
- E Grasset
- E Grasset
- E Griffiths
- E Harper
- E Hervieux
- E Hoogakker
- E Huaman
- E Jenner
- E Jones
- E Jovine
- E Jurdell
- E Kasem
- E Kefalidi
- E Kostov
- E Laugzemys
- E M Harrison
- E M Saeed Taha
- E Macdermid
- E Macdonald
- E Mamdouh
- E Marks
- E Mcaleer
- E Monaghan
- E N W Yeung
- E Niyirera
- E Nofal
- E P Refianti Sutanto
- E Panieri
- E Preckailaite
- E Rausa
- E Schadde
- E Snyder
- E Teasdale
- E Temoche
- E Thomas
- E Upchurch
- E Veronese
- E Williams
- E Woin
- E Y A Palkhi
- F A Asele
- F A Naranjo Aristizã Bal
- F Abantanga
- F Abd El-Salam
- F Alakaloko
- F Altoe
- F Coccolini
- F Deichsel
- F Di Franco
- F Elgendy
- F Elkady
- F Elzowawi
- F Fernandez-Bueno
- F Frade
- F Fujii
- F Koumpa
- F M Iqbal
- F N Rahmawati
- F Nada
- F Owusu
- F Pata
- F Primavesi
- F Regalado
- F S Peck
- F Sauvat
- F Schmitt
- F Tale
- F Taylor
- F Th'ng
- F Wogensen
- F Wogensen
- F Y Lam
- F Zheng
- F-M Iordache
- G Azzie
- G Borda Luque
- G Dawnay
- G El Ashal
- G Elena
- G Gemenetzis
- G Gravante
- G H Devadasar
- G Humm
- G Irwin
- G Kouraklis
- G Landolfo
- G Lap
- G Lim
- G Luca Lamanna
- G M Machain Vega
- G Maharaj
- G Manrique Sila
- G Manrrique Sila
- G Mclachlan
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- G Tessera
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- G Tugnoli
- G Williams
- H A Segovia Lohse
- H Abbas Dharamshi
- H Abudeeb
- H Ahmed
- H Ahmed El-Badawy
- H Ali
- H Ali Mostafa
- H Anderson-Knight
- H Burns
- H Cruz
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- H Dawoud
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- H El-Kashef
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- H Jordan
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- H Khaled
- H Koh
- H Kretzmann
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- H N Lakshmi
- H Nair
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- H Rooney
- H Royson
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- H Safa
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- H Tafazal
- H Thorarinsdottir
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- H Whewell
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- H Youssef
- H Zain Elabdin
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- H Zidan
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- I Ortega-Vazquez
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- I S Bharj
- I Youssef
- I-B Diaconescu
- J A Cabala Chiong
- J A Cabala Chiong
- J A Carreira
- J A Garcia-Marin
- J A Montoya Botero
- J Adeniran
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- J Almy
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- J H Jara Quezada
- J H Youssif
- J Hamasaki
- J Heath
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- J J Al-Faifi
- J J Tan
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- J Kabba
- J L Rodicio
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- J Lewis
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- J M Clements
- J M Vergara Celis
- J Ma
- J Marcelo Delgado
- J Menegussi
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- K To
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- K Zamarin
- L A J Jayasooriya Arachchige
- L Alberto Valente Laufer
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- L-A Mercado Rodriguez
- L-J Anyanwu
- M A Alfarsi
- M A Baky Fahmy
- M A E H Mohamed
- M A Fathi Abozyed
- M Abbas
- M Abd El Slam
- M Abdelkader
- M Abdelraheim
- M Abdelshafy
- M Abdulgawad
- M Abdulkhalek Habeeb
- M Abo Raya
- M Aboraya
- M Abozaid
- M Abuseif
- M Afzal
- M Agius
- M Aguilera
- M Akhtar
- M Al-Mousa
- M Aledrisy
- M Alghamdi
- M Alhendy
- M Ali Ghonaim
- M Ali Yavuz
- M Aljiffry
- M Alkhouri
- M Allam
- M Alrahawy
- M Alrajraji
- M AlRowais
- M Alsaggaf
- M Alzahrani
- M Alzahrani
- M Ameen
- M Amer
- M Ammar
- M Amreia
- M Angel Paludi
- M Asal
- M Ashur Sherif
- M Attard
- M Baheeg
- M Bakhaidar
- M Baldacchino
- M Benger
- M Beuran
- M Bezzina
- M Boal
- M Boijsen
- M Boshnaq
- M Bukari
- M C Mendoza Arango
- M C Mendoza Arango
- M C Mendoza Arango
- M Carlucci
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- M Dal Canto
- M Dar
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- M Edye
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- M Elazoul
- M Elbermawy
- M Elfil
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- M Elsayed
- M Elsehimy
- M Elshaer
- M Elshobary
- M Elsiddig
- M Elzayat
- M Etman
- M F Leung
- M Farhad
- M Farid Hosh
- M Firdouse
- M Gamal Mohamad Hamad
- M Gemeah
- M Ghassan Alwafai
- M Ghetia
- M Ghetia
- M Ghoneem
- M Gillespie
- M Gimzewska
- M Gomah
- M Goodstein
- M Griffiths
- M Gumar
- M Habib Ibrahim
- M Hache-Marliere
- M Hafez
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- M Hanafy
- M Hanrahan
- M Hanrahan
- M Hanrahan
- M Hashish
- M Hassan
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- M Hemmila
- M Hjertberg
- M Hogea
- M Hussain
- M Husseini
- M I Villegas
- M Ismail
- M Jacobe
- M Jarmin
- M Jawaid
- M Jha
- M Jokubauskas
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- M Karakahya
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- M Kennedy
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- M Khalili
- M Kimaro
- M Kontos
- M L Pimenta
- M Leal
- M Linares Delgado
- M Livingston
- M Lopez
- M M Furqan
- M M Hassan Mohammed
- M M Metwally
- M M Palliyil
- M Machaca
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- M Makinde
- M Marta Modolo
- M Mayasari
- M Mccarthy
- M Mccarthy
- M Mendez
- M Mesalam
- M Mezeil Telfah
- M Mlotshwa
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- M Mohan
- M Monteleone
- M Montrimaite
- M Moron Munhoz
- M Morsi
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- M Mustafa
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- M Oludara
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- M Puttick
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- M Ramcharn
- M Rangarajan
- M Rashad
- M Rashid
- M Rashid Minhas Qadir
- M Rodriguez Castro
- M S Ali Muhammad Gohar
- M S J Wilson
- M S J Wilson
- M S Weinstein
- M Saad
- M Sabry Ammar
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- M Saeed
- M Salama
- M Salma
- M Scott
- M Seif
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- M Siguantay
- M Sion
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- M Stoddart
- M Sund
- M Swaroop
- M Sykes
- M Taher
- M Tun
- M Turner
- M Utter
- M Varcada
- M Vartic
- M Vella-Baldacchino
- M Wagener
- M Warda
- M Worku
- M Young-Han Kim
- M Zakir
- M Zalabia
- M Zapata Ponze De Leon
- M Zapata Ponze De Leon
- M Zidan
- M Zikry
- M Zuber
- N A Nik Abdullah
- N Abd El Hamid
- N Ahmed Attallah
- N Akeel
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- N Botto
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- N F Watson
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- N Green
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- N J Smart
- N J Wright
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- N S Abebe
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- N Soubhy El-Shahat
- N Starr
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- N Zanini
- O Abbo
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- O Taiwo
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- O Ziff
- P A Assouto
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- P C Munipalle
- P Capleton
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- P Sutton
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- P Weber
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- P-O Lundgren
- Q Alimi
- Q Alimi
- R Adams
- R Allott
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- R Alyami
- R Amandito
- R Anderson
- R Araujo
- R Ardley
- R Balmaceda
- R Barrionuevo Ojeda
- R Beyene
- R Blundell
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- R Lages Simoes
- R Lawther
- R Lilford
- R M H Balila
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- R-M Bratu
- S A Alnuqaydan
- S A Durand
- S Abd Elmageed Barakat
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- S G Gosling
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- S Khan
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- S King
- S Koh
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- S M Contreras Mérida
- S M Lakhani
- S M Sundstrom
- S Magdy Ahmed
- S Mahdi
- S Man Yeng Chiu
- S Mcaleer
- S Mehrez
- S Mikalauskas
- S Mitrasinovic
- S Mouttalib
- S Nadkarni
- S Ng
- S Nigo
- S O'Neill
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- S Pai
- S Parthiban
- S Ramzi
- S Ray
- S Rayne
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- S Roncali
- S Roy
- S S Prasad
- S Saad
- S Said Elkolaly
- S Samy
- S Sani Ali
- S Sarsik
- S Sarwary
- S Satoskar
- S Shaikh
- S Shehata
- S Sheth
- S Shu
- S Sierra
- S Singh
- S Sinha
- S Sivaganesh
- S Stock
- S Tabiri
- S Talukder
- S Talukder
- S Tewari
- S Tharmalingam
- S Tou
- S V Kinnera
- S Vivekanantham
- S Ward
- S Wondimu
- S Zegarra
- S Zeidan
- S-H Kim
- S-P Hosein
- T A M Malik
- T Akeem Lawal
- T Alzayat
- T Arulampalam
- T B Wold
- T Barker
- T Boyce
- T Brogden
- T Chun
- T Clark
- T E Glover
- T Ebogo Ngwa
- T F Jones
- T Falconer Hall
- T Farooq
- T Fautz
- T Fernandes Giuriato
- T Fozard
- T Fozard
- T Khan
- T Kumar
- T M Drake
- T Mak
- T Muhammad Yaseen
- T Naqvi
- T Newton
- T Nouh
- T O'Connor
- T Pezas
- T Poskus
- T Razek B Marinkovic
- T S Hettiarachchi
- T Sherman
- T Stasinou
- T Urbonas
- T W Tilston
- T White
- T Xerri
- T Yaseen
- U Alamoudi
- U Gunnarsson
- U Gustafsson
- U Hantour
- U Karabacak
- U Walsh
- V Ambrozeviciute
- V Beisa
- V D Palomino Castillo
- V Despotidis
- V Gadhvi
- V Graffeille
- V Graffieille
- V Grassi
- V J P Nsengimana
- V Jennings
- V Jotautas
- V K Proctor
- V Kong
- V M Quintero Riaza
- V Parent
- V Patel
- V Punja
- V Sallinen
- V Shatkar
- V Summerour
- V Thanusan
- W Adham
- W Anwer
- W Beasley
- W C Ho
- W C Soon
- W Chachulski
- W Forno
- W Guo
- W Hawkins
- W Ho
- W Hutch
- W J Lossius
- W L Messa Aguilar
- W L Messa Aguilar
- W Milligan
- W Milligan
- W Pino
- W S Li
- W S M Kithsiri Janakantha Senanayake
- Y Abd El Salam
- Y Abd Elrasoul
- Y Abd-Elrasoul
- Y Aigrain
- Y Cengiz
- Y El Shoura
- Y Elfouly
- Y Hegazy
- Y Ibrahim
- Y Imorou Souaibou
- Y Macchitella
- Y N Neo
- Y P Mogan
- Y Rajjoub
- Y Reddy
- Y Salama
- Y Sinha
- Z Chan
- Z Dambrauskas
- Z Hassan
- Z Iftikhar
- Z Jaffry
- Z Mikwar
- Z Oof
- Z Urniezius
- Z Zhang
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2016
- Field of study
Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).
Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.
Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days.
Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)
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
- Felix Michael
- Ferdousi Tamanna
- Fernandes de Oliveira Darli
- Fernandes de Souza Rachel
- Fernandez Ferrer Marianelly
- Fernandez Portilla Emilio
- Fernandez Wilson Miriam Daniela
- Ferraz Schopf Luciano
- Flores Carbajal Lenny
- Ford Kat
- Forero Ladino Angelica Maria
- Fouda Mohamed Fayez
- Fouly Mariam Albatoul Nageh
- Fouquet-Languillat Virginie
- Fourcade Laurent
- Fowler Kathryn L
- Fox Sarah
- Franco Helena
- Furtado Meyer Karine
- Furtado Mariana
- Féliz Erick
- Gabriel Comba
- Gad Dalia
- Gadepalli Samir
- Gai A.
- Galdeano Marcelo
- Gall Caroline Le
- Gamage Tharanga
- Gamboa Kcomt Segundo
- Gao Zhigang
- Gao Zhou Chong
- Garcia Martinez Humberto
- Garcia Isidora
- Garcia Virginia
- Garcia-Aparicio Luis
- García Miriam
- Gargum Sondas Ali
- Garnier Hanna
- Garrett-Cox Robin
- Gasana Georges
- Gatzinsky Vladimir
- Gavrila Bogdan
- Gavrilovska-Brzanov Aleksandra
- Gee Oliver
- Gerus Sylwester
- Geze Şükran
- Ghabayen Amir Talat Sheda
- Ghallab Alaa
- Ghaly Khaled Abd elrahman
- Ghanem Waleed H.
- Ghayth Sumayyah
- Ghazzawi Ihsan
- Ghilardi Silva Ximena
- Ghorab Islam Abdelmonem
- Ghosh Dhruv
- Gilardi Jose
- Girão Tauffer Mariana
- 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
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- 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
Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
Background: 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