18 research outputs found
Ethanol Intoxication and Road Accident Trauma Statistics in a Tertiary Hospital Complex of Cotonou City in Benin Republic
No full textBackground: Road traffic accidents are among the leading causes of morbidity and mortality in Benin Republic, in other words, a serious public health problem here. Consumption of alcoholic drinks is known as an important risk factor for road accidents. The aim of this preliminary study was to determine alcohol ingestion and its relationship with victims of road traffic accidents in Cotonou City, Benin.Methods: It is a descriptive and analytic study which carried out during January-June 2016. In this study, ethanol concentration was measured in the victims of traffic accidents’ blood. Information related to the injured people, their social characteristics, circumstances of accident occurrence, and the outcomes were also collected. Results: In this study, 80 victims of road accidents were included. Most of the victims were men (64%), youth under 40 years (70%), and motorcyclists (83%). The overall prevalence of ethanol ingestion was 55% (64% in motorcyclists and 25% in motorists). Approximately, 16% of them were involved in fatal accidents. There was no association between ethanol ingestion frequency and factors such as the age of the injured, condition of the injured at the time of the accident, time of accident, and road condition on which the accident happened. Conclusion: This study indicated that a lot of traffic accident victims had consumed alcoholic drinks shortly before the accident in Benin
Anesthesiologists' demography in French-speaking Sub-Saharan Africa: the impact of fifteen years of Belgo-Beninese cooperation
No full textBelgium has been collaborating with the French-speaking University of Abomey-Calavi in Cotonou (Republic of Benin) for 15 years to train anesthesiologists for Sub-Saharan French-speaking African countries. At the end of the nineties, Sub-Saharan Africa was the only part of the world with a decreasing number of anesthesiologists. Thanks to various financial supports coming mainly from Belgian governmental cooperation funds, the program has been successful in reversing the demographic trend and even started a multiplying effect through the creation of schools for nurse-anesthetists, and through the creation of new training centers for physician anesthesiologists. Sixty-nine anesthesiologists from 13 countries graduated from Cotonou, 59 (85.5%) of whom actually choose to work in Africa. At least 40 of them teach anesthesia, playing a key role in the creation of new schools and training centers
Pediatric anesthesia in developing countries: experience in the two main university hospitals of Benin in West Africa
No full textRabies transmission risks during peripartum--Two cases and a review of the literature.
No full textInternational audienceWe report two cases of probable rabies in near-term/at-term pregnant women in sub-Saharan Africa and Asia. One baby was delivered by caesarean section and the other one vaginally. Both received post-exposure prophylaxis (PEP), including RIG and vaccine and both are alive and healthy, at 9 and 24 months, respectively. We found 14 other published cases of infants born from rabid mothers. One confirmed case of rabies transmission occurred. The other children born from rabid mothers, with or without caesarean section, did not acquire rabies, and were still healthy at the time of reporting, with or without post-exposure prophylaxis. Mother-to-child transmission of rabies is possible, but rare, because rabies virus is not present in blood and exposure of the baby's mucosa to maternal infectious fluids and tissue seems limited. A conservative approach should however, be adopted, and rabies PEP, including RIG, be administered as soon as possible to babies born from probably rabid mothers. Whether cesarean-section clearly provides prevention remains unclear. Rabies can be prevented in pregnant women by PEP administration. Rabies cell-culture vaccines are safe and effective and can be administered to pregnant and lactating women, as well as newborns. Efforts must focus on raising rabies awareness in the general population, as well as in healthcare workers
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
No full text3427sinoneBackground: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 percent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.noneGlasbey, James C; Adisa, Adewale O; Costas‐Chavarri, Ainhoa; Qureshi, Ahmad U; Allen‐Ingabire, Jean C; Salem, Hosni Khairy; Kojo, Anyomih Theophilus Teddy; Tabiri, Stephen; Nepogodiev, Dmitri; Lilford, Richard J; Harrison, Ewen M; Pinkney, Thomas D; Smart, Neil; Bhangu, Aneel; Verjee, Azmina; Runigamugabo, Emmy; Glasbey, James; Bhangu, Aneel; Ademuyiwa, Adesoji O; Adisa, Adewale O; Aguilera, Maria Lorena; Altamini, Afnan; Alexander, Philip; Al‐Saqqa, Sara W; Borda‐Luque, Giuliano; Cornick, Jen; Costas‐Chavarri, Ainhoa; Drake, Thomas M; Fergusson, Stuart J; Fitzgerald, J Edward; Glasbey, James; Ingabire, J.C Allen; Ismaïl, Lawani; Jaffry, Zahra; Salem, Hosni Khairy; Khatri, Chetan; Kirby, Andrew; Kojo, Anyomih Theophilus Teddy; Lapitan, Marie Carmela; Lilford, Richard; Mihaljevic, Andre L; Mohan, Midhun; Morton, Dion; Mutabazi, Alphonse Zeta; Nepogodiev, Dmitri; Ntirenganya, Faustin; Ots, Riinu; Pata, Francesco; Pinkney, Thomas; Poškus, Tomas; Qureshi, Ahmad Uzair; Medina, Antonio Ramos‐De; Rayne, Sarah; Recinos, Gustavo; Søreide, Kjetil; Shaw, Catherine A; Shu, Sebastian; Spence, Richard; Smart, Neil; Tabiri, Stephen; Lilford, Richard; Morton, Dion; Harrison, Ewen M; Bhangu, Aneel; Khatri, Chetan; Gobin, Neel; Freitas, Ana Vega; Hall, Nigel; Kim, Sung‐Hee; Negida, Ahmed; Khairy, Hosni; Jaffry, Zahra; Chapman, Stephen J; Arnaud, Alexis P; Tabiri, Stephen; Recinos, Gustavo; Manipal, Cutting Edge; Mohan, Midhun; Amandito, Radhian; Shawki, Marwan; Hanrahan, Michael; Pata, Francesco; Zilinskas, Justas; Roslani, April Camilla; Goh, Cheng Chun; Ademuyiwa, Adesoji O; Irwin, Gareth; Shu, Sebastian; Luque, Laura; Shiwani, Hunain; Altamimi, Afnan; Alsaggaf, Mohammed Ubaid; Fergusson, Stuart J; Spence, Richard; Rayne, Sarah; Jeyakumar, Jenifa; Cengiz, Yucel; Raptis, Dmitri A; Glasbey, James C; Modolo, Maria Marta; Iyer, Dushyant; King, Sebastian; Arthur, Tom; Nahar, Sayeda Nazmum; Waterman, Ade; Ismaïl, Lawani; Walsh, Michael; Agarwal, Arnav; Zani, Augusto; Firdouse, Mohammed; Rouse, Tyler; Liu, Qinyang; Correa, Juan Camilo; Salem, Hosni Khairy; Talving, Peep; Worku, Mengistu; Arnaud, Alexis; Tabiri, Stephen; Kalles, Vassilis; Aguilera, Maria Lorena; Recinos, Gustavo; Kumar, Basant; Kumar, Sunil; Amandito, Radhian; Quek, Roy; Pata, Francesco; Ansaloni, Luca; Altibi, Ahmed; Venskutonis, Donatas; Zilinskas, Justas; Poskus, Tomas; Whitaker, John; Msosa, Vanessa; Tew, Yong Yong; Farrugia, Alexia; Borg, Elaine; Medina, Antonio Ramos‐De; Bentounsi, Zineb; Ademuyiwa, Adesoji O; Søreide, Kjetil; Gala, Tanzeela; Al‐Slaibi, Ibrahim; Tahboub, Haya; Alser, Osaid H.; Romani, Diego; Shu, Sebestian; Major, Piotr; Mironescu, Aurel; Bratu, Matei; Kourdouli, Amar; Ndajiwo, Aliyu; Altwijri, Abdulaziz; Alsaggaf, Mohammed Ubaid; Gudal, Ahmad; Jubran, Al Faifi; Seisay, Sam; Lieske, Bettina; Rayne, Sarah; Spence, Richard; Ortega, Irene; Jeyakumar, Jenifa; Senanayake, Kithsiri J.; Abdulbagi, Omar; Cengiz, Yucel; Raptis, Dmitri; Altinel, Yuksel; Kong, Chia; Teasdale, Ella; Irwin, Gareth; Stoddart, Michael; Kabariti, Rakan; Suresh, Sukrit; Gash, Katherine; Narayanan, Ragavan; Maimbo, Mayaba; Fermani, Claudio; Balmaceda, Ruben; Modolo, Maria Marta; Macdermid, Ewan; Gobin, Neel; Chenn, Roxanne; Yong, Cheryl Ou; Edye, Michael; Jarmin, Martin; D'amours, Scott K; Iyer, Dushyant; Youssef, Daniel; Phillips, Nicholas; Brown, Jason; George, Robert; Koh, Cherry; Warren, Oliver; Hanley, Isaac; Dickfos, Marilla; Nawara, Clemens; Öfner, Dietmar; Primavesi, Florian; Mitul, Ashrarur Rahman; Mahmud, Khalid; Hussain, Margub; Hakim, Hafiz; Kumar, Tapan; Oosterkamp, Antje; Assouto, Pamphile A; Lawani, Ismail; Souaibou, Yacoubou Imorou; Tun, Aung Kyaw; Chong, Chean Leung; Devadasar, Giridhar H; Chong, Chean Leung; Qadir, Muhammad Rashid Minhas; Aung, Kyaw Phyo; Yeo, Lee Shi; Chong, Chean Leung; Castillo, Vanessa Dina Palomino; Munhoz, Monique Moron; Moreira, Gisele; De Castro Segundo, Luiz Carlos Barros; Ferreira, Salim Anderson Khouri; Careta, Maíra Cassa; Kim, Stella Binna; De Sousa, Alexandre Venancio; Cury, Alyne Daltri Lazzarini; Miguel, Gustavo Peixoto Soares; De Freitas, Ana Vega Carreiro; Guasti, Barbara Pereira Silvestre Julia; Vianna, Pinto; Felipe, Carolina Oliveira; Laufer, Luis Alberto Valente; Altoe, Fernanda; Da Silva, Luana Ayres; Pimenta, Marina Luiza; Giuriato, Thiago Fernandes; Morais, Paulo Alves Bezerra; Araujo, Jessica Souza Luiz Rafael; Menegussi, Juliana; Leal, Marisa; Lima, Caio Vinícius Barroso; Tatagiba, Luiza Sarmento; Leal, Antônio; Santos, Diogo Vinicius; Fraga, Gustavo Pereira; Simoes, Romeo Lages; Stock, Simon; Nigo, Samuel; Kabba, Juana; Ngwa, Tagang Ebogo; Brown, James; King, Sebastian; Zani, Augusto; Azzie, Georges; Firdouse, Mohammed; Kushwaha, Sameer; Agarwal, Arnav; Bailey, Karen; Cameron, Brian; Livingston, Michael; Horobjowsky, Alexandre; Deckelbaum, Dan L; Razek, Tarek; Marinkovic, Boris; Grasset, Eugenio; D'aguzan, Nicole; Grasset, Eugenio; Jimenez, Julio; Macchiavello, Roberto; Zhang, Zhongtao; Guo, Wei; Oh, Junyeong; Zheng, Fei; Montes, Irene; Sierra, Sebastian; Mendez, Manuela; Villegas, Maria Isabel; Arango, Maria Clara Mendoza; Mendoza, Ivan; Naranjo Aristizã¡bal, Fred Alexander; Botero, Jaime Andres Montoya; Riaza, Victor Manuel Quintero; Restrepo, Jakeline; Morales, Carlos; Arango, Maria Clara Mendoza; Cruz, Herman; Munera, Alejandro; Arango, Maria Clara Mendoza; Karlo, Robert; Domini, Edgar; Mihanovic, Jakov; Radic, Mihael; Zamarin, Kresimir; Pezelj, Nikica; Hache‐Marliere, Manuel; Lemaire, Sylvia Batista; Rivas, Ruben; Khyrallh, Ahmed; Hassan, Ahamed; Shimy, Gamal; Baky Fahmy, Mohamed A; Nabawi, Ayman; Elfil, Mohamed; Ghoneem, Mohamed; Gohar, Muhammad El‐Saied Ahmad Muhammad; Asal, Mohamed; Abdelkader, Mostafa; Gomah, Mahmoud; Rashwan, Hayssam; Karkeet, Mohamed; Gomaa, Ahmed; Hasan, Amr; Elgebaly, Ahmed; Saleh, Omar; Fattah, Ahmad Abdel; Gouda, Abdullah; Elshafay, Abd Elrahman; Gharib, Abdalla; Menshawy, Ahmed; Hanafy, Mohammed; Al‐Mallah, Abdullah; Abdulgawad, Mahmoud; Baheeg, Mohamad; Alhendy, Mohammed; AbdelFattah, Ibrahim; Kenibar, Abdalla; Osman, Omar; Gemeah, Mostafa; Mohammed, Ahmed; Adel, Abdalrahman; Gharib, Abdalla; Mohammed, Abdelrahman; Sayed, Abdelrahman; Abozaid, Mohamed; Kotb, Ahmed Hafez El‐Badri; Ata, Ali Amin Ahmed; Nasr, Mohammed; Alkammash, Abdelrahman; Saeed, Mohammed; El Hamid, Nader Abd; Attia, Attia Mohamed; El Galeel, Ahmed Abd; Elbanby, Eslam; El‐Dien, Khalid Salah; Hantour, Usama; Alahmady, Omar; Mansour, Billal; Elkorashy, Amr Muhammad; Taha, Emad Mohamed Saeed; Lasheen, Kholod Tarek; Elkolaly, Salma Said; Abdel‐Wahab, Nehal Yosri Elsayed; Abozyed, Mahmoud Ahmed Fathi; Adel, Ahmed; Saeed, Ahmed Moustafa; El Sayed, Gehad Samir; Youssif, Jehad Hassan; Ahmed, Soliman Magdy; El‐Shahat, Nermeen Soubhy; Khedr, Abd El‐Rahman Hegazy; Elsebaaye, Abdelrhman Osama; Elzayat, Mohamed; Abdelraheim, Mohamed; Elzayat, Ibrahim; Warda, Mahmoud; El Deen, Khaled Naser; Elnemr, Abdelrhman Essam; Salah, Omar; Abbas, Mohamed; Rashad, Mona; Elzayyat, Ibrahim; Hemeda, Dalia; Tawfik, Gehad; Salama, Mai; Khaled, Hazem; Seisa, Mohamed; Elshaer, Kareem; Hussein, Abdelfatah; Elkhadrawi, Mahmoud; Afifi, Ahmed Mohamed; Ebrahim, Osama Saadeldeen; Metwally, Mahmoud Mohamed; Elmelegy, Rowida; Elsawahly, Diaa Moustafa Elbendary; Safa, Hisham; Nofal, Eman; Elbermawy, Mohamed; Ghazy, Ahmed Abdelmotaleb; Samih, Hisham; Abdelgelil, Asmaa; Abdelghany, Sarah; El Kholy, Ahmed; Aboraya, Metwally; Elkady, Fatma; Salma, Mahmoud; Samy, Sarah; Fakher, Reem; Aboarab, Aya; Samir, Ahmed; Sakr, Ahmed; Haroun, Abdelrahman; Al‐Aarag, Asmaa Abdel‐Rahman; Elkholy, Ahmed; Elshanwany, Sally; Ghanem, Esraa; Tammam, Ahmed; Hammad, Ali Mohamed; El Shoura, Yousra; El Ashal, Gehad; Khairy, Hosni; Antar, Sarah; Mehrez, Sara; Abdelshafy, Mahmoud; Hamad, Maha Gamal Mohamad; Hosh, Mona; Abdallah, Emad; Magdy, Basma; Alzayat, Thuraya; Gamaly, Elsayed; Elfeki, Hossam; Abouzahra, Amany; Elsheikh, Shereen; Elgendy, Fatimah I; El‐Salam, Fathia Abd; Seifelnasr, Osama; Ammar, Mohamed; Eysa, Athar; Sadek, Aliaa; Toeema, Aliaa Gamal; Nasr, Aly; Abuseif, Mohamed; Zidan, Hagar; Barakat, Sara Abd Elmageed; Elsayed, Nadin; Elrasoul, Yasmin Abd; Elkelany, Ahmed; Ammar, Mohamed Sabry; Mustafa, Mennat‐Allah; Hegazy, Yasmin; Etman, Mohamed; Saad, Samar; Alrahawy, Mahmoud; Raslan, Ahmed; Morsi, Mahmoud; Rslan, Ahmed; Sabry, Ahmed; Elwakil, Hager; Shaker, Heba; Zidan, Hagar; Abd‐Elrasoul, Yasmin; Elkelany, Ahmed; El‐Kashef, Hussein; Shaalan, Mohamed; Tarek, Areej; Elwan, Ayman; Nayel, Ahmed Ragab; Seif, Mostafa; Elwan, Ayman; Emadeldin, Doaa; Ghonaim, Mohamed Ali; Almallah, Ahmad; Fouad, Ahmed; Sayma, Eman Adel; Elbatahgy, Ahmad; El‐Ma'doul, Angham Solaiman; Mosad, Ahmed; Tolba, Hager; Elsorogy, Diaa Eldin Abdelazeem Amin; Mostafa, Hassan Ali; Omar, Amira Atef; El Hameed, Ola Sherief Abd; Lasheen, Ahmed; El Salam, Yasser Abd; Morsi, Ashraf; Ismail, Mohammed; El‐badawy, Hager Ahmed; Amer, Mohamed A; Elkelany, Ahmed; Elkelany, Ahmed; El‐Hamouly, Ahmed Sabry; Attallah, Noura A.; Mosalum, Omnia; Afandy, Ahmed; Mokhtar, Ahmed; Abouelnasr, Alaa; Ayad, Sara; Shaker, Ramdan; Sakr, Rokia; Shaker, Ramadan; Amreia, Mahmoud; Elsobky, Soaad; Mustafa, Mohamed; El Magd, Ahmed Abo; Marey, Abeer; Hafez, Amr Tarek; Zalabia, Mohamed F; Mohamed, Mohamed Moamen; Fadel, Amr; Ahmed, Emad Ali; Ali, Ahmad; Alwafai, Mohammad Ghassan; Dwydar, Abdullah; Kharsa, Sara; Mamdouh, Ehab; El‐Sheemy, Hatem; AlYoussef, Ibrahim; Aly, Abouelatta Khairy; Aldalaq, Ahmad; Alnawam, Ehab; Alkhabbaz, Dalia; Saad, Mahmoud; Hussein, Shady; Elazayem, Ahmed Abo; Meshref, Ahmed; Elashmawy, Marwa; Mousa, Mohammed; Nashaat, Ahmad; Ghanem, Sara; Elsayed, Zaynab M; Elwaey, Aya; Elkadsh, Iman; Darweesh, Mariam; Mohameden, Ahmed; Hafez, Mennaallah; Badr, Ahmed; Badwy, Assmaa; El Slam, Mohamed Abd; Elazoul, Mohamed; Al‐Nahrawi, Safwat; Eldamaty, Lotfy; Nada, Fathee; Ameen, Mohamed; Hagar, Aya; Elsehimy, Mohamed; Aboraya, Mohammad; Dawoud, Hossam; El Mesery, Shorouk; El Gendy, Abeer; Abdelkareem, Ahmed; Marey, Ahmed Safwan; Allam, Mostafa; Shehata, Sherif; Abozeid, Khaled; Elshobary, Marwa; Fahiem, Ahmed; Sarsik, Sameh; Hashish, Amel; Zidan, Mohamed; Hashish, Mohamed; Aql, Shaimaa; Elhendawy, Abdelaziz Osman Abdelaziz; Husseini, Mohamed; Kasem, Esraa; Gheith, Ahmed; Elfouly, Yasmin; Soliman, Ahmed Ragab; Ibrahim, Yasmein; Elfouly, Nesma; Fawzy, Ahmed; Hassan, Ahmed; Rashid, Mohammad; Elsherbiny, Abdallah Salah; Sieda, Basem; Badwi, Nermin M; Mohammed, Mohammed Mustafa Hassan; Mohamed, Osama; Habeeb, Mohammad Abdulkhalek; Worku, Mengistu; Starr, Nichole; Desta, Semay; Wondimu, Sahlu; Abebe, Nebyou Seyoum; Thomas, Efeson; Asele, Frehun Ayele; Dabessa, Daniel; Abebe, Nebiyou Seyoum; Zerihun, Abebe Bekele; Mentula, Panu; Leppäniemi, Ari; Sallinen, Ville; Scalabre, Aurelien; Frade, Fernanda; Irtan, Sabine; Graffeille, Vivien; Gaignard, Elodie; Alimi, Quentin; Alimi, Quentin; Graffieille, Vivien; Gaignard, Elodie; Abbo, Olivier; Mouttalib, Sofia; Bouali, Ourdia; Hervieux, Erik; Aigrain, Yves; Botto, Nathalie; Faure, Alice; Fievet, Lucile; Panait, Nicoleta; Eyssartier, Emilie; Schmitt, Francoise; Podevin, Guillaume; Parent, Valentine; Martin, Amandine; Arnaud, Alexis Pierre; Muller, Cecile; Bonnard, Arnaud; Peycelon, Matthieu; Abantanga, Francis; Boakye‐Yiadom, Kwaku; Bukari, Mohammed; Owusu, Frank; Awuku‐Asabre, Joseph; Tabiri, Stephen; Bray, Lemuel Davies; Lytras, Dimitrios; Psarianos, Kyriakos; Bamicha, Anastasia; Kefalidi, Eirini; Gemenetzis, Georgios; Dervenis, Christos; Gouvas, Nikolaos; Agalianos, Christos; Kontos, Michail; Kouraklis, Gregory; Karousos, Dimitrios; Germanos, Stylianos; Marinos, Constantinos; Anthoulakis, Christos; Nikoloudis, Nikolaos; Mitroudis, Nikolaos; Recinos, Gustavo; Estupinian, Sergio; Forno, Walter; Azmitia, José René Arévalo; Cabrera, Carla Cecilia Ramãrez; Guevara, Romeo; Aguilera, Maria; Mendez, Napoleon; Mendizabal, Cesar Augusto Azmitia; Ramazzini, Pablo; Urquizu, Mario Contreras; Tale, Fernando; Soley, Rafael; Barrios, Emanuel; Barrios, Emmanuel; Rodríguez, Daniel Estuardo Marroquín; Velásquez, Carlos Iván Pérez; Mérida, Sara María Contreras; Regalado, Francisco; Lopez, Mario; Siguantay, Miguel; Lam, Fong Yee; Szeto, Kylie Joan‐yi; Szeto, Charing Cheuk Ling; Li, Wing Sum; Li, Kieran Ka Kei; Leung, Man Fung; Mak, Tony; Ng, Simon; Prasad, SS; Kirishnan, Anand; Gyanchandani, Nidhi; Kumar, Bylapudi Seshu; Rangarajan, Muthukumaran; Bhat, Sriram; Sreedharan, Anjana; Kinnera, S.V.; Reddy, Yella; Venugopal, Caranj; Kumar, Sunil; Mittal, Abhishek; Nadkarni, Shravan; Lakshmi, Harish Neelamraju; Malik, Puneet; Limaye, Neel; Pai, Srinivas; Jain, Pratik; Khajanchi, Monty; Satoskar, Savni; Satoskar, Rajeev; Mahamood, Abid Bin; Sutanto, Eldaa Prisca Refianti; Soeselo, Daniel Ardian; Tedjaatmadja, Chintya; Rahmawati, Fitriana Nur; Amandito, Radhian; Mayasari, Maria; Al‐Hasani, Ruqaya Kadhim Mohammed Jawad; Al‐Hameedi, Hasan Ismael Ibraheem; Ibraheem, Hasan Ismael; Al‐Azraqi, Israa Abdullah Aziz; Sabeeh, Lubna; Kamil, Rahma; Shawki, Marwan; Telfah, Muwaffaq Mezeil; Rasendran, Amoudtha; Sheehan, Jacqueline; Kerley, Robert; Normile, Caoimhe; Gilbert, Richard William; Song, Jiheon; Dablouk, Mohamed; Mauro, Linnea; Dablouk, Mohammed Osman; Hanrahan, Michael; Kielty, Paul; Marks, Eleanor; Gosling, Simon; Mccarthy, Michelle; Rasendran, Amoudtha; Mirghani, Diya; Naqvi, Syed Altaf; Wong, Chee Siong; Chung, Siyi; D'cruz, Reuban; Cahill, Ronan; Gosling, Simon George; Mccarthy, Michelle; Rasendran, Amoudtha; Fahy, Ciara; Song, Jiheon; Hanrahan, Michael; Cadogan, Diana Duarte; Powell, Anna; Gilbert, Richard; Clifford, Caroline; Normile, Caoimhe; Driscoll, Aoife; Paul, Stassen; Lee, Chris; Bowe, Ross; Hutch, William; Hanrahan, Michael; Mohan, Helen; O'neill, Maeve; Mealy, Kenneth; Danelli, Piergiorgio; Bondurri, Andrea; Maffioli, Anna; Pasini, Mario; Pata, Giacomo; Roncali, Stefano; Silvani, Paolo; Carlucci, Michele; Faccincani, Roberto; Bonavina, Luigi; Macchitella, Yuri; Ceriani, Chiara; Tugnoli, Gregorio; Di Saverio, Salomone; Khattab, Khaled; Paludi, Miguel Angel; Pata, Domenica; Cloro, Luigi Maria; Allegri, Andrea; Ansaloni, Luca; Coccolini, Federico; Veronese, Ezio; Bortolasi, Luca; Hasheminia, Alireza; Nastri, Giacomo; Canto, Massimiliano Dal; Cucumazzo, Stefano; Pata, Francesco; Benevento, Angelo; Tessera, Gaetano; Grandinetti, Pier Paolo; Maniscalco, Alessio; Lamanna, Giovanni Luca; Turati, Luca; Sgroi, Giovanni; Rausa, Emanuele; Villa, Roberta; Monteleone, Michela; Merlini, David; Coccolini, Federico; Ansaloni, Luca; Allegri, Andrea; Grassi, Veronica; Cirocchi, Roberto; Cacurri, Alban; Waleed, Hamza; Diab, Ahmed; Elzowawi, Fathi; Jokubauskas, Mantas; Varkalys, Karolis; Venskutonis, Donatas; Pranevicius, Robertas; Ambrozeviciute, Viktorija; Juciute, Simona; Skardžiukaitė, Austė; Venskutonis, Donatas; Bradulskis, Saulius; Urbanavicius, Linas; Austraite, Aiste; Riauka, Romualdas; Zilinskas, Justas; Dambrauskas, Zilvinas; Karumnas, Paulius; Urniezius, Zigmantas; Zilinskiene, Reda; Rudzenskaite, Anele; Usaityte, Ausrine; Montrimaite, Margarita; Kaselis, Nerijus; Strazdas, Andrius; Jokubonis, Kristijonas; Maceviciute, Kornelija; Beisa, Virgilijus; Poskus, Tomas; Strupas, Kestutis; Laugzemys, Erikas; Kolosov, Andrej; Jotautas, Valdemaras; Rakita, Ignas; Mikalauskas, Saulius; Kazanavicius, Darius; Rackauskas, Rokas; Strupas, Kestutis; Poskus, Tomas; Beisa, Virgilijus; Rakauskas, Ritauras; Preckailaite, Egle; Coomber, Ross; Johnson, Kenneth; Nowers, Jennifer; Periasammy, Dineshwary; Salleh, Afizah; Das, Andre; Tze, Reuben Goh Ern; Kumar, Milaksh Nirumal; Abdullah, Nik Azim Nik; Kosai, Nik Ritza; Taher, Mustafa; Rajan, Reynu; Chong, Hoong Yin; Roslani, April Camilla; Goh, Cheng Chun; Agius, Marija; Borg, Elaine; Bezzina, Maureen; Bugeja, Roberta; Vella‐Baldacchino, Martinique; Spina, Andrew; Psaila, Josephine; Francois‐Coridon, Helene; Tolg, Cecilia; Colombani, Jean‐Francois; Diaz‐Zorrilla, Carmina; De La Medina, Antonio Ramos‐; Gonzalez, Samantha Corro‐Diaz; Jacobe, Mário; Mapasse, Domingos; Snyder, Elizabeth; Oumer, Ramadan; Osman, Mohammed; Mohammad, Aminu; Anyanwu, Lofty‐John; Sheshe, Abdulrahman; Adesina, Alaba; Faturoti, Olubukola; Taiwo, Ogechukwu; Ibrahim, Muhammad Habib; Nasir, Abdulrasheed A; Suleiman, Siyaka Itopa; Adeniyi, Adewale; Adesanya, Opeoluwa; Adebanjo, Ademola; Osuoji, Roland; Atobatele, Kazeem; Ogunyemi, Ayokunle; Williams, Omolara; Oludara, Mobolaji; Oshodi, Olabode; Ademuyiwa, Adesoji; Lawal, AbdulRazzaq Oluwagbemiga; Alakaloko, Felix; Elebute, Olumide; Osinowo, Adedapo; Bode, Christopher; Adesuyi, Abidemi; Tade, Adesoji; Adekoya, Adeleke; Nwokoro, Collins; Ayandipo, Omobolaji O; Lawal, Taiwo Akeem; Ajao, Akinlabi E; Ali, Samuel Sani; Odeyemi, Babatunde; Olori, Samson; Popoola, Ademola; Adeyeye, Ademola; Adeniran, James; Lossius, William J.; Havemann, Ingemar; Thorsen, Kenneth; Narvestad, Jon Kristian; Soreide, Kjetil; Wold, Trude Beate; Nymo, Linn; Elsiddig, Mohammed; Dar, Manzoor; Bhopal, Kamran Faisal; Iftikhar, Zainab; Furqan, Muhammad Mohsin; Nighat, Bakhtiar; Jawaid, Masood; Khalique, Abdul; Zil‐E‐Ali, Ahsan; Rashid, Anam; Dharamshi, Hasnain Abbas; Naqvi, Tahira; Faraz, Ahmad; Anwar, Abdul Wahid; Yaseen, Tahir Muhammad; Shamsi, Ghina Shamim; Shamsi, Ghina; Yaseen, Tahir; Anwer, Wahid; Decoud, Horacio Paredes; Aguilera, Omar; Alvarez, Ismael Isaac Zelada; Delgado, Juan Marcelo; Vega, Gustavo Miguel Machain; Lohse, Helmut Alfredo Segovia; Aguilar, Wendy Leslie Messa; Chiong, Jose Antonio Cabala; Bautista, Ana Cecilia Manchego; Huaman, Eduardo; Zegarra, Sergio; Camacho, Rony; Celis, Jose María Vergara; Pozo, Diego Alonso Romani; Hamasaki, José; Temoche, Edilberto; Herrera‐Matta, Jaime; Torres, Carla Pierina García; Barreda, Luis Miguel Alvarez; Ojeda, Ronald Renato Barrionuevo; Garaycochea, Octavio; Mollo, Melanie Castro; Delgado, Mitchelle Solange De Fã Tima Linare; Fujii, Francisco; Bautista, Ana Cecilia Manchego; Aguilar, Wendy Leslie Messa; Chiong, Jose Antonio Cabala; Durand, Susana Yrma Aranzabal; Basto, Carlos Alejandro Arroyo; Rojas, Nelson Manuel Urbina; Yip, Sebastian Bernardo Shu; Vergara, Ana Lucia Contreras; Moran, Andrea Echevarria Rosas; Luque, Giuliano Borda; Castro, Manuel Rodriguez; Jaramillo, Ramon Alvarado; Sila, George Manrique; Lopez, Crislee Elizabeth; De Leon, Mardelangel Zapata Ponze; Machaca, Massiell; Huaraya, Ronald Coasaca; Arenas, Andy; López, Crislee; Puma, Clara Milagros Herrera; Pino, Wilfredo; Hinojosa, Christian; De Leon, Melanie Zapata Ponze; Limache, Susan; Sila, George Manrrique; Rodriguez, Layza‐Alejandra Mercado; Melo, Renato; Costa‐Maia, Jose; Muralha, Nuno; Sauvat, Frederique; Dan, Ionasc; Hogea, Mircea; Eduard, Pandi; Bratu, Razvan‐Matei; Beuran, Mircea; Diaconescu, Ionut‐Bogdan; Martian, Bogdan‐Valeriu; Iordache, Florin‐Mihail; Vartic, Mihaela; Vida, Lucian Corneliu; Muntean, Liviu Iuliu; Mironescu, Aurel Sandu; Nsengimana, Vizir Jean Paul; Niragire, Alice; Ingabire, Jean De La Croix Allen; Niyirera, Eugene; Zanini, Nicola; Jovine, Elio; Landolfo, Giovanni; Alomar, Ibrahim N.; Alnuqaydan, Saleh A.; Altwigry, Abdulrahman M.; Othman, Moayad; Osman, Nohad; Alqahtani, Enas; Alzahrani, Mohammed; Alyami, Rifan; Aljohani, Emad; Alhabli, Ibrahim; Mikwar, Zaher; Almuallem, Sultan; Aljohani, Emad; Alyami, Rifan; Alzahrani, Mohammed; Nawawi, Abrar; Bakhaidar, Mohamad; Maghrabi, Ashraf A.; Alsaggaf, Mohammed; Aljiffry, Murad; Altaf, Abdulmalik; Khoja, Ahmad; Habeebullah, Alaa; Akeel, Nouf; Ghandora, Nashat; Almoflihi, Abdullah; Huwait, Abdulmalik; Al‐shammari, Abeer; Al‐Mousa, Mashael; Alghamdi, Masood; Adham, Walid; Albeladi, Bandar; Alfarsi, Muayad Ahmed; Mahdi, Atif; Al Awwad, Saad; Altamimi, Afnan; Nouh, Thamer; Hassanain, Mazen; Aldhafeeri, Salman; Sadig, Nawal; Algohary, Osama; Aledrisy, Mohannad; Gudal, Ahmad; Alrifaie, Ahmad; AlRowais, Mohammed; Althwainy, Amani; Shabkah, Alaa; Alamoudi, Uthman; Alrajraji, Mawaddah; Alghamdi, Basim; Aljohani, Saud; Daqeeq, Abdullah; Al‐Faifi, Jubran J; Jennings, Vicky;
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
No full textnone3427noBackground: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 percent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.noneGlasbey, James C; Adisa, Adewale O; Costas‐Chavarri, Ainhoa; Qureshi, Ahmad U; Allen‐Ingabire, Jean C; Salem, Hosni Khairy; Kojo, Anyomih Theophilus Teddy; Tabiri, Stephen; Nepogodiev, Dmitri; Lilford, Richard J; Harrison, Ewen M; Pinkney, Thomas D; Smart, Neil; Bhangu, Aneel; Verjee, Azmina; Runigamugabo, Emmy; Glasbey, James; Bhangu, Aneel; Ademuyiwa, Adesoji O; Adisa, Adewale O; Aguilera, Maria Lorena; Altamini, Afnan; Alexander, Philip; Al‐Saqqa, Sara W; Borda‐Luque, Giuliano; Cornick, Jen; Costas‐Chavarri, Ainhoa; Drake, Thomas M; Fergusson, Stuart J; Fitzgerald, J Edward; Glasbey, James; Ingabire, J.C Allen; Ismaïl, Lawani; Jaffry, Zahra; Salem, Hosni Khairy; Khatri, Chetan; Kirby, Andrew; Kojo, Anyomih Theophilus Teddy; Lapitan, Marie Carmela; Lilford, Richard; Mihaljevic, Andre L; Mohan, Midhun; Morton, Dion; Mutabazi, Alphonse Zeta; Nepogodiev, Dmitri; Ntirenganya, Faustin; Ots, Riinu; Pata, Francesco; Pinkney, Thomas; Poškus, Tomas; Qureshi, Ahmad Uzair; Medina, Antonio Ramos‐De; Rayne, Sarah; Recinos, Gustavo; Søreide, Kjetil; Shaw, Catherine A; Shu, Sebastian; Spence, Richard; Smart, Neil; Tabiri, Stephen; Lilford, Richard; Morton, Dion; Harrison, Ewen M; Bhangu, Aneel; Khatri, Chetan; Gobin, Neel; Freitas, Ana Vega; Hall, Nigel; Kim, Sung‐Hee; Negida, Ahmed; Khairy, Hosni; Jaffry, Zahra; Chapman, Stephen J; Arnaud, Alexis P; Tabiri, Stephen; Recinos, Gustavo; Manipal, Cutting Edge; Mohan, Midhun; Amandito, Radhian; Shawki, Marwan; Hanrahan, Michael; Pata, Francesco; Zilinskas, Justas; Roslani, April Camilla; Goh, Cheng Chun; Ademuyiwa, Adesoji O; Irwin, Gareth; Shu, Sebastian; Luque, Laura; Shiwani, Hunain; Altamimi, Afnan; Alsaggaf, Mohammed Ubaid; Fergusson, Stuart J; Spence, Richard; Rayne, Sarah; Jeyakumar, Jenifa; Cengiz, Yucel; Raptis, Dmitri A; Glasbey, James C; Modolo, Maria Marta; 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Abouzahra, Amany; Elsheikh, Shereen; Elgendy, Fatimah I; El‐Salam, Fathia Abd; Seifelnasr, Osama; Ammar, Mohamed; Eysa, Athar; Sadek, Aliaa; Toeema, Aliaa Gamal; Nasr, Aly; Abuseif, Mohamed; Zidan, Hagar; Barakat, Sara Abd Elmageed; Elsayed, Nadin; Elrasoul, Yasmin Abd; Elkelany, Ahmed; Ammar, Mohamed Sabry; Mustafa, Mennat‐Allah; Hegazy, Yasmin; Etman, Mohamed; Saad, Samar; Alrahawy, Mahmoud; Raslan, Ahmed; Morsi, Mahmoud; Rslan, Ahmed; Sabry, Ahmed; Elwakil, Hager; Shaker, Heba; Zidan, Hagar; Abd‐Elrasoul, Yasmin; Elkelany, Ahmed; El‐Kashef, Hussein; Shaalan, Mohamed; Tarek, Areej; Elwan, Ayman; Nayel, Ahmed Ragab; Seif, Mostafa; Elwan, Ayman; Emadeldin, Doaa; Ghonaim, Mohamed Ali; Almallah, Ahmad; Fouad, Ahmed; Sayma, Eman Adel; Elbatahgy, Ahmad; El‐Ma'doul, Angham Solaiman; Mosad, Ahmed; Tolba, Hager; Elsorogy, Diaa Eldin Abdelazeem Amin; Mostafa, Hassan Ali; Omar, Amira Atef; El Hameed, Ola Sherief Abd; Lasheen, Ahmed; El Salam, Yasser Abd; Morsi, Ashraf; Ismail, Mohammed; El‐badawy, Hager Ahmed; Amer, Mohamed A; Elkelany, Ahmed; Elkelany, Ahmed; El‐Hamouly, Ahmed Sabry; Attallah, Noura A.; Mosalum, Omnia; Afandy, Ahmed; Mokhtar, Ahmed; Abouelnasr, Alaa; Ayad, Sara; Shaker, Ramdan; Sakr, Rokia; Shaker, Ramadan; Amreia, Mahmoud; Elsobky, Soaad; Mustafa, Mohamed; El Magd, Ahmed Abo; Marey, Abeer; Hafez, Amr Tarek; Zalabia, Mohamed F; Mohamed, Mohamed Moamen; Fadel, Amr; Ahmed, Emad Ali; Ali, Ahmad; Alwafai, Mohammad Ghassan; Dwydar, Abdullah; Kharsa, Sara; Mamdouh, Ehab; El‐Sheemy, Hatem; AlYoussef, Ibrahim; Aly, Abouelatta Khairy; Aldalaq, Ahmad; Alnawam, Ehab; Alkhabbaz, Dalia; Saad, Mahmoud; Hussein, Shady; Elazayem, Ahmed Abo; Meshref, Ahmed; Elashmawy, Marwa; Mousa, Mohammed; Nashaat, Ahmad; Ghanem, Sara; Elsayed, Zaynab M; Elwaey, Aya; Elkadsh, Iman; Darweesh, Mariam; Mohameden, Ahmed; Hafez, Mennaallah; Badr, Ahmed; Badwy, Assmaa; El Slam, Mohamed Abd; Elazoul, Mohamed; Al‐Nahrawi, Safwat; Eldamaty, Lotfy; Nada, Fathee; Ameen, Mohamed; Hagar, Aya; Elsehimy, Mohamed; Aboraya, Mohammad; 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Tale, Fernando; Soley, Rafael; Barrios, Emanuel; Barrios, Emmanuel; Rodríguez, Daniel Estuardo Marroquín; Velásquez, Carlos Iván Pérez; Mérida, Sara María Contreras; Regalado, Francisco; Lopez, Mario; Siguantay, Miguel; Lam, Fong Yee; Szeto, Kylie Joan‐yi; Szeto, Charing Cheuk Ling; Li, Wing Sum; Li, Kieran Ka Kei; Leung, Man Fung; Mak, Tony; Ng, Simon; Prasad, SS; Kirishnan, Anand; Gyanchandani, Nidhi; Kumar, Bylapudi Seshu; Rangarajan, Muthukumaran; Bhat, Sriram; Sreedharan, Anjana; Kinnera, S.V.; Reddy, Yella; Venugopal, Caranj; Kumar, Sunil; Mittal, Abhishek; Nadkarni, Shravan; Lakshmi, Harish Neelamraju; Malik, Puneet; Limaye, Neel; Pai, Srinivas; Jain, Pratik; Khajanchi, Monty; Satoskar, Savni; Satoskar, Rajeev; Mahamood, Abid Bin; Sutanto, Eldaa Prisca Refianti; Soeselo, Daniel Ardian; Tedjaatmadja, Chintya; Rahmawati, Fitriana Nur; Amandito, Radhian; Mayasari, Maria; Al‐Hasani, Ruqaya Kadhim Mohammed Jawad; Al‐Hameedi, Hasan Ismael Ibraheem; Ibraheem, Hasan Ismael; Al‐Azraqi, Israa Abdullah Aziz; Sabeeh, Lubna; Kamil, Rahma; Shawki, Marwan; Telfah, Muwaffaq Mezeil; Rasendran, Amoudtha; Sheehan, Jacqueline; Kerley, Robert; Normile, Caoimhe; Gilbert, Richard William; Song, Jiheon; Dablouk, Mohamed; Mauro, Linnea; Dablouk, Mohammed Osman; Hanrahan, Michael; Kielty, Paul; Marks, Eleanor; Gosling, Simon; Mccarthy, Michelle; Rasendran, Amoudtha; Mirghani, Diya; Naqvi, Syed Altaf; Wong, Chee Siong; Chung, Siyi; D'cruz, Reuban; Cahill, Ronan; Gosling, Simon George; Mccarthy, Michelle; Rasendran, Amoudtha; Fahy, Ciara; Song, Jiheon; Hanrahan, Michael; Cadogan, Diana Duarte; Powell, Anna; Gilbert, Richard; Clifford, Caroline; Normile, Caoimhe; Driscoll, Aoife; Paul, Stassen; Lee, Chris; Bowe, Ross; Hutch, William; Hanrahan, Michael; Mohan, Helen; O'neill, Maeve; Mealy, Kenneth; Danelli, Piergiorgio; Bondurri, Andrea; Maffioli, Anna; Pasini, Mario; Pata, Giacomo; Roncali, Stefano; Silvani, Paolo; Carlucci, Michele; Faccincani, Roberto; Bonavina, Luigi; Macchitella, Yuri; Ceriani, Chiara; Tugnoli, Gregorio; Di Saverio, Salomone; Khattab, Khaled; Paludi, Miguel Angel; Pata, Domenica; Cloro, Luigi Maria; Allegri, Andrea; Ansaloni, Luca; Coccolini, Federico; Veronese, Ezio; Bortolasi, Luca; Hasheminia, Alireza; Nastri, Giacomo; Canto, Massimiliano Dal; Cucumazzo, Stefano; Pata, Francesco; Benevento, Angelo; Tessera, Gaetano; Grandinetti, Pier Paolo; Maniscalco, Alessio; Lamanna, Giovanni Luca; Turati, Luca; Sgroi, Giovanni; Rausa, Emanuele; Villa, Roberta; Monteleone, Michela; Merlini, David; Coccolini, Federico; Ansaloni, Luca; Allegri, Andrea; Grassi, Veronica; Cirocchi, Roberto; Cacurri, Alban; Waleed, Hamza; Diab, Ahmed; Elzowawi, Fathi; Jokubauskas, Mantas; Varkalys, Karolis; Venskutonis, Donatas; Pranevicius, Robertas; Ambrozeviciute, Viktorija; Juciute, Simona; Skardžiukaitė, Austė; Venskutonis, Donatas; Bradulskis, Saulius; Urbanavicius, Linas; Austraite, Aiste; Riauka, Romualdas; Zilinskas, Justas; Dambrauskas, Zilvinas; Karumnas, Paulius; Urniezius, Zigmantas; Zilinskiene, Reda; Rudzenskaite, Anele; Usaityte, Ausrine; Montrimaite, Margarita; Kaselis, Nerijus; Strazdas, Andrius; Jokubonis, Kristijonas; Maceviciute, Kornelija; Beisa, Virgilijus; Poskus, Tomas; Strupas, Kestutis; Laugzemys, Erikas; Kolosov, Andrej; Jotautas, Valdemaras; Rakita, Ignas; Mikalauskas, Saulius; Kazanavicius, Darius; Rackauskas, Rokas; Strupas, Kestutis; Poskus, Tomas; Beisa, Virgilijus; Rakauskas, Ritauras; Preckailaite, Egle; Coomber, Ross; Johnson, Kenneth; Nowers, Jennifer; Periasammy, Dineshwary; Salleh, Afizah; Das, Andre; Tze, Reuben Goh Ern; Kumar, Milaksh Nirumal; Abdullah, Nik Azim Nik; Kosai, Nik Ritza; Taher, Mustafa; Rajan, Reynu; Chong, Hoong Yin; Roslani, April Camilla; Goh, Cheng Chun; Agius, Marija; Borg, Elaine; Bezzina, Maureen; Bugeja, Roberta; Vella‐Baldacchino, Martinique; Spina, Andrew; Psaila, Josephine; Francois‐Coridon, Helene; Tolg, Cecilia; Colombani, Jean‐Francois; Diaz‐Zorrilla, Carmina; De La Medina, Antonio Ramos‐; Gonzalez, Samantha Corro‐Diaz; Jacobe, Mário; Mapasse, Domingos; Snyder, Elizabeth; Oumer, Ramadan; Osman, Mohammed; Mohammad, Aminu; Anyanwu, Lofty‐John; Sheshe, Abdulrahman; Adesina, Alaba; Faturoti, Olubukola; Taiwo, Ogechukwu; Ibrahim, Muhammad Habib; Nasir, Abdulrasheed A; Suleiman, Siyaka Itopa; Adeniyi, Adewale; Adesanya, Opeoluwa; Adebanjo, Ademola; Osuoji, Roland; Atobatele, Kazeem; Ogunyemi, Ayokunle; Williams, Omolara; Oludara, Mobolaji; Oshodi, Olabode; Ademuyiwa, Adesoji; Lawal, AbdulRazzaq Oluwagbemiga; Alakaloko, Felix; Elebute, Olumide; Osinowo, Adedapo; Bode, Christopher; Adesuyi, Abidemi; Tade, Adesoji; Adekoya, Adeleke; Nwokoro, Collins; Ayandipo, Omobolaji O; Lawal, Taiwo Akeem; Ajao, Akinlabi E; Ali, Samuel Sani; Odeyemi, Babatunde; Olori, Samson; Popoola, Ademola; Adeyeye, Ademola; Adeniran, James; Lossius, William J.; Havemann, Ingemar; Thorsen, Kenneth; Narvestad, Jon Kristian; Soreide, Kjetil; Wold, Trude Beate; Nymo, Linn; Elsiddig, Mohammed; Dar, Manzoor; Bhopal, Kamran Faisal; Iftikhar, Zainab; Furqan, Muhammad Mohsin; Nighat, Bakhtiar; Jawaid, Masood; Khalique, Abdul; Zil‐E‐Ali, Ahsan; Rashid, Anam; Dharamshi, Hasnain Abbas; Naqvi, Tahira; Faraz, Ahmad; Anwar, Abdul Wahid; Yaseen, Tahir Muhammad; Shamsi, Ghina Shamim; Shamsi, Ghina; Yaseen, Tahir; Anwer, Wahid; Decoud, Horacio Paredes; Aguilera, Omar; Alvarez, Ismael Isaac Zelada; Delgado, Juan Marcelo; Vega, Gustavo Miguel Machain; Lohse, Helmut Alfredo Segovia; Aguilar, Wendy Leslie Messa; Chiong, Jose Antonio Cabala; Bautista, Ana Cecilia Manchego; Huaman, Eduardo; Zegarra, Sergio; Camacho, Rony; Celis, Jose María Vergara; Pozo, Diego Alonso Romani; Hamasaki, José; Temoche, Edilberto; Herrera‐Matta, Jaime; Torres, Carla Pierina García; Barreda, Luis Miguel Alvarez; Ojeda, Ronald Renato Barrionuevo; Garaycochea, Octavio; Mollo, Melanie Castro; Delgado, Mitchelle Solange De Fã Tima Linare; Fujii, Francisco; Bautista, Ana Cecilia Manchego; Aguilar, Wendy Leslie Messa; Chiong, Jose Antonio Cabala; Durand, Susana Yrma Aranzabal; Basto, Carlos Alejandro Arroyo; Rojas, Nelson Manuel Urbina; Yip, Sebastian Bernardo Shu; Vergara, Ana Lucia Contreras; Moran, Andrea Echevarria Rosas; Luque, Giuliano Borda; Castro, Manuel Rodriguez; Jaramillo, Ramon Alvarado; Sila, George Manrique; Lopez, Crislee Elizabeth; De Leon, Mardelangel Zapata Ponze; Machaca, Massiell; Huaraya, Ronald Coasaca; Arenas, Andy; López, Crislee; Puma, Clara Milagros Herrera; Pino, Wilfredo; Hinojosa, Christian; De Leon, Melanie Zapata Ponze; Limache, Susan; Sila, George Manrrique; Rodriguez, Layza‐Alejandra Mercado; Melo, Renato; Costa‐Maia, Jose; Muralha, Nuno; Sauvat, Frederique; Dan, Ionasc; Hogea, Mircea; Eduard, Pandi; Bratu, Razvan‐Matei; Beuran, Mircea; Diaconescu, Ionut‐Bogdan; Martian, Bogdan‐Valeriu; Iordache, Florin‐Mihail; Vartic, Mihaela; Vida, Lucian Corneliu; Muntean, Liviu Iuliu; Mironescu, Aurel Sandu; Nsengimana, Vizir Jean Paul; Niragire, Alice; Ingabire, Jean De La Croix Allen; Niyirera, Eugene; Zanini, Nicola; Jovine, Elio; Landolfo, Giovanni; Alomar, Ibrahim N.; Alnuqaydan, Saleh A.; Altwigry, Abdulrahman M.; Othman, Moayad; Osman, Nohad; Alqahtani, Enas; Alzahrani, Mohammed; Alyami, Rifan; Aljohani, Emad; Alhabli, Ibrahim; Mikwar, Zaher; Almuallem, Sultan; Aljohani, Emad; Alyami, Rifan; Alzahrani, Mohammed; Nawawi, Abrar; Bakhaidar, Mohamad; Maghrabi, Ashraf A.; Alsaggaf, Mohammed; Aljiffry, Murad; Altaf, Abdulmalik; Khoja, Ahmad; Habeebullah, Alaa; Akeel, Nouf; Ghandora, Nashat; Almoflihi, Abdullah; Huwait, Abdulmalik; Al‐shammari, Abeer; Al‐Mousa, Mashael; Alghamdi, Masood; Adham, Walid; Albeladi, Bandar; Alfarsi, Muayad Ahmed; Mahdi, Atif; Al Awwad, Saad; Altamimi, Afnan; Nouh, Thamer; Hassanain, Mazen; Aldhafeeri, Salman; Sadig, Nawal; Algohary, Osama; Aledrisy, Mohannad; Gudal, Ahmad; Alrifaie, Ahmad; AlRowais, Mohammed; Althwainy, Amani; Shabkah, Alaa; Alamoudi, Uthman; Alrajraji, Mawaddah; Alghamdi, Basim; Aljohani, Saud; Daqeeq, Abdullah; Al‐Faifi, Jubran J; Jennings, Vicky; Ngayu, Nyawira
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study
No full textBackground: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. Methods: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. Results: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33–4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76–2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6% ) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42–0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14–0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11–0.44) and SSI (OR 0.21 95% CI 0.09–0.45). Conclusion: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. Trial registration: NCT02179112
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
No full textBackground Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.
Methods Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.
Results This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.
Conclusions Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
No full textBackground: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 percent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries [Elektronisk resurs]
No full textBackground: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.AuthorOverflow(1112
