Cargando…
Emergency care in 59 low- and middle-income countries: a systematic review
OBJECTIVE: To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). METHODS: We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians a...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
World Health Organization
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581659/ https://www.ncbi.nlm.nih.gov/pubmed/26478615 http://dx.doi.org/10.2471/BLT.14.148338 |
_version_ | 1782391597987528704 |
---|---|
author | Obermeyer, Ziad Abujaber, Samer Makar, Maggie Stoll, Samantha Kayden, Stephanie R Wallis, Lee A Reynolds, Teri A |
author_facet | Obermeyer, Ziad Abujaber, Samer Makar, Maggie Stoll, Samantha Kayden, Stephanie R Wallis, Lee A Reynolds, Teri A |
author_sort | Obermeyer, Ziad |
collection | PubMed |
description | OBJECTIVE: To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). METHODS: We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. FINDINGS: We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. CONCLUSION: Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings. |
format | Online Article Text |
id | pubmed-4581659 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | World Health Organization |
record_format | MEDLINE/PubMed |
spelling | pubmed-45816592015-10-16 Emergency care in 59 low- and middle-income countries: a systematic review Obermeyer, Ziad Abujaber, Samer Makar, Maggie Stoll, Samantha Kayden, Stephanie R Wallis, Lee A Reynolds, Teri A Bull World Health Organ Systematic Reviews OBJECTIVE: To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). METHODS: We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. FINDINGS: We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. CONCLUSION: Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings. World Health Organization 2015-08-01 2015-05-26 /pmc/articles/PMC4581659/ /pubmed/26478615 http://dx.doi.org/10.2471/BLT.14.148338 Text en (c) 2015 The authors; licensee World Health Organization. This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL. |
spellingShingle | Systematic Reviews Obermeyer, Ziad Abujaber, Samer Makar, Maggie Stoll, Samantha Kayden, Stephanie R Wallis, Lee A Reynolds, Teri A Emergency care in 59 low- and middle-income countries: a systematic review |
title | Emergency care in 59 low- and middle-income countries: a systematic review |
title_full | Emergency care in 59 low- and middle-income countries: a systematic review |
title_fullStr | Emergency care in 59 low- and middle-income countries: a systematic review |
title_full_unstemmed | Emergency care in 59 low- and middle-income countries: a systematic review |
title_short | Emergency care in 59 low- and middle-income countries: a systematic review |
title_sort | emergency care in 59 low- and middle-income countries: a systematic review |
topic | Systematic Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581659/ https://www.ncbi.nlm.nih.gov/pubmed/26478615 http://dx.doi.org/10.2471/BLT.14.148338 |
work_keys_str_mv | AT obermeyerziad emergencycarein59lowandmiddleincomecountriesasystematicreview AT abujabersamer emergencycarein59lowandmiddleincomecountriesasystematicreview AT makarmaggie emergencycarein59lowandmiddleincomecountriesasystematicreview AT stollsamantha emergencycarein59lowandmiddleincomecountriesasystematicreview AT kaydenstephanier emergencycarein59lowandmiddleincomecountriesasystematicreview AT wallisleea emergencycarein59lowandmiddleincomecountriesasystematicreview AT reynoldsteria emergencycarein59lowandmiddleincomecountriesasystematicreview AT emergencycarein59lowandmiddleincomecountriesasystematicreview |