Operative mortality in resource-limited settings: the experience of Medecins Sans Frontieres in 13 countries.

Hdl Handle:
http://hdl.handle.net/10144/112663
Title:
Operative mortality in resource-limited settings: the experience of Medecins Sans Frontieres in 13 countries.
Authors:
Chu, K M; Ford, N; Trelles, M
Journal:
Archives of Surgery
Abstract:
OBJECTIVE: To determine operative mortality in surgical programs from resource-limited settings. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study of 17 surgical programs in 13 developing countries by 1 humanitarian organization, Médecins Sans Frontières, was performed between January 1, 2001, and December 31, 2008. Participants included patients undergoing surgical procedures. MAIN OUTCOME MEASURE: Operative mortality. Determinants of mortality were modeled using logistic regression. RESULTS: Between 2001 and 2008, 19,643 procedures were performed on 18,653 patients. Among these, 8329 procedures (42%) were emergent; 7933 (40%) were for obstetric-related pathology procedures and 2767 (14%) were trauma related. Operative mortality was 0.2% (31 deaths) and was associated with programs in conflict settings (adjusted odds ratio [AOR] = 4.6; P = .001), procedures performed under emergency conditions (AOR = 20.1; P = .004), abdominal surgical procedures (AOR = 3.4; P = .003), hysterectomy (AOR = 12.3; P = .001), and American Society of Anesthesiologists classifications of 3 to 5 (AOR = 20.2; P < .001). CONCLUSIONS: Surgical care can be provided safely in resource-limited settings with appropriate minimum standards and protocols. Studies on the burden of surgical disease in these populations are needed to improve service planning and delivery. Quality improvement programs are needed for the various stakeholders involved in surgical delivery in these settings.
Affiliation:
Medecines Sans Frontieres
Issue Date:
Aug-2010
URI:
http://hdl.handle.net/10144/112663
DOI:
10.1001/archsurg.2010.137
PubMed ID:
20713922
Language:
en
ISSN:
1538-3644
Appears in Collections:
Surgery

Full metadata record

DC FieldValue Language
dc.contributor.authorChu, K Men
dc.contributor.authorFord, Nen
dc.contributor.authorTrelles, Men
dc.date.accessioned2010-10-08T13:24:11Z-
dc.date.available2010-10-08T13:24:11Z-
dc.date.issued2010-08-
dc.identifier.citationOperative mortality in resource-limited settings: the experience of Medecins Sans Frontieres in 13 countries. 2010, 145 (8):721-5 Arch Surgen
dc.identifier.issn1538-3644-
dc.identifier.pmid20713922-
dc.identifier.doi10.1001/archsurg.2010.137-
dc.identifier.urihttp://hdl.handle.net/10144/112663-
dc.description.abstractOBJECTIVE: To determine operative mortality in surgical programs from resource-limited settings. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study of 17 surgical programs in 13 developing countries by 1 humanitarian organization, Médecins Sans Frontières, was performed between January 1, 2001, and December 31, 2008. Participants included patients undergoing surgical procedures. MAIN OUTCOME MEASURE: Operative mortality. Determinants of mortality were modeled using logistic regression. RESULTS: Between 2001 and 2008, 19,643 procedures were performed on 18,653 patients. Among these, 8329 procedures (42%) were emergent; 7933 (40%) were for obstetric-related pathology procedures and 2767 (14%) were trauma related. Operative mortality was 0.2% (31 deaths) and was associated with programs in conflict settings (adjusted odds ratio [AOR] = 4.6; P = .001), procedures performed under emergency conditions (AOR = 20.1; P = .004), abdominal surgical procedures (AOR = 3.4; P = .003), hysterectomy (AOR = 12.3; P = .001), and American Society of Anesthesiologists classifications of 3 to 5 (AOR = 20.2; P < .001). CONCLUSIONS: Surgical care can be provided safely in resource-limited settings with appropriate minimum standards and protocols. Studies on the burden of surgical disease in these populations are needed to improve service planning and delivery. Quality improvement programs are needed for the various stakeholders involved in surgical delivery in these settings.en
dc.language.isoenen
dc.rightsArchived with thanks to Archives of Surgery (Chicago, Ill. : 1960)en
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshAltruismen
dc.subject.meshDeveloping Countriesen
dc.subject.meshEmergency Medical Servicesen
dc.subject.meshFemaleen
dc.subject.meshHumansen
dc.subject.meshLogistic Modelsen
dc.subject.meshMaleen
dc.subject.meshMedical Missions, Officialen
dc.subject.meshMiddle Ageden
dc.subject.meshSurgical Procedures, Operativeen
dc.subject.meshYoung Adulten
dc.titleOperative mortality in resource-limited settings: the experience of Medecins Sans Frontieres in 13 countries.en
dc.contributor.departmentMedecines Sans Frontieresen
dc.identifier.journalArchives of Surgeryen

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