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In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone

BACKGROUND: Postoperative mortality rate is one of six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. The primary aim of this study was to measure the postoperative mortality rate in Tanzania’s Lake Zone to provide a bas...

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Autores principales: Wurdeman, Taylor, Strader, Christopher, Alidina, Shehnaz, Barash, David, Citron, Isabelle, Kapologwe, Ntuli, Maina, Erastus, Massaga, Fabian, Mazhiqi, Adelina, Meara, John G., Menon, Gopal, Reynolds, Cheri, Sydlowski, Meaghan, Varallo, John, Maongezi, Sarah, Ulisubisya, Mpoki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752880/
https://www.ncbi.nlm.nih.gov/pubmed/32995932
http://dx.doi.org/10.1007/s00268-020-05802-w
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author Wurdeman, Taylor
Strader, Christopher
Alidina, Shehnaz
Barash, David
Citron, Isabelle
Kapologwe, Ntuli
Maina, Erastus
Massaga, Fabian
Mazhiqi, Adelina
Meara, John G.
Menon, Gopal
Reynolds, Cheri
Sydlowski, Meaghan
Varallo, John
Maongezi, Sarah
Ulisubisya, Mpoki
author_facet Wurdeman, Taylor
Strader, Christopher
Alidina, Shehnaz
Barash, David
Citron, Isabelle
Kapologwe, Ntuli
Maina, Erastus
Massaga, Fabian
Mazhiqi, Adelina
Meara, John G.
Menon, Gopal
Reynolds, Cheri
Sydlowski, Meaghan
Varallo, John
Maongezi, Sarah
Ulisubisya, Mpoki
author_sort Wurdeman, Taylor
collection PubMed
description BACKGROUND: Postoperative mortality rate is one of six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. The primary aim of this study was to measure the postoperative mortality rate in Tanzania’s Lake Zone to provide a baseline for surgical strengthening efforts. The secondary aim was to measure the effect of Safe Surgery 2020, a multi-component intervention to improve surgical quality, on postoperative mortality after 10 months. METHODS: We prospectively collected data on postoperative mortality from 20 health centers, district hospitals, and regional hospitals in Tanzania’s Lake Zone over two time periods: pre-intervention (February to April 2018) and post-intervention (March to May 2019). We analyzed postoperative mortality rates by procedure type. We used logistic regression to determine the impact of Safe Surgery 2020 on postoperative mortality. RESULTS: The overall average in-hospital non-obstetric postoperative mortality rate for all surgery procedures was 2.62%. The postoperative mortality rates for laparotomy were 3.92% and for cesarean delivery was 0.24%. Logistic regression demonstrated no difference in the postoperative mortality rate after the Safe Surgery 2020 intervention. CONCLUSIONS: Our results inform national surgical planning in Tanzania by providing a sub-national baseline estimate of postoperative mortality rates for multiple surgical procedures and serve as a basis from which to measure the impact of future surgical quality interventions. Our study showed no improvement in postoperative mortality after implementation of Safe Surgery 2020, possibly due to low power to detect change. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00268-020-05802-w) contains supplementary material, which is available to authorized users.
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spelling pubmed-77528802020-12-28 In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone Wurdeman, Taylor Strader, Christopher Alidina, Shehnaz Barash, David Citron, Isabelle Kapologwe, Ntuli Maina, Erastus Massaga, Fabian Mazhiqi, Adelina Meara, John G. Menon, Gopal Reynolds, Cheri Sydlowski, Meaghan Varallo, John Maongezi, Sarah Ulisubisya, Mpoki World J Surg Surgery in Low and Middle Income Countries BACKGROUND: Postoperative mortality rate is one of six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. The primary aim of this study was to measure the postoperative mortality rate in Tanzania’s Lake Zone to provide a baseline for surgical strengthening efforts. The secondary aim was to measure the effect of Safe Surgery 2020, a multi-component intervention to improve surgical quality, on postoperative mortality after 10 months. METHODS: We prospectively collected data on postoperative mortality from 20 health centers, district hospitals, and regional hospitals in Tanzania’s Lake Zone over two time periods: pre-intervention (February to April 2018) and post-intervention (March to May 2019). We analyzed postoperative mortality rates by procedure type. We used logistic regression to determine the impact of Safe Surgery 2020 on postoperative mortality. RESULTS: The overall average in-hospital non-obstetric postoperative mortality rate for all surgery procedures was 2.62%. The postoperative mortality rates for laparotomy were 3.92% and for cesarean delivery was 0.24%. Logistic regression demonstrated no difference in the postoperative mortality rate after the Safe Surgery 2020 intervention. CONCLUSIONS: Our results inform national surgical planning in Tanzania by providing a sub-national baseline estimate of postoperative mortality rates for multiple surgical procedures and serve as a basis from which to measure the impact of future surgical quality interventions. Our study showed no improvement in postoperative mortality after implementation of Safe Surgery 2020, possibly due to low power to detect change. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00268-020-05802-w) contains supplementary material, which is available to authorized users. Springer International Publishing 2020-09-29 2021 /pmc/articles/PMC7752880/ /pubmed/32995932 http://dx.doi.org/10.1007/s00268-020-05802-w Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Surgery in Low and Middle Income Countries
Wurdeman, Taylor
Strader, Christopher
Alidina, Shehnaz
Barash, David
Citron, Isabelle
Kapologwe, Ntuli
Maina, Erastus
Massaga, Fabian
Mazhiqi, Adelina
Meara, John G.
Menon, Gopal
Reynolds, Cheri
Sydlowski, Meaghan
Varallo, John
Maongezi, Sarah
Ulisubisya, Mpoki
In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone
title In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone
title_full In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone
title_fullStr In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone
title_full_unstemmed In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone
title_short In-Hospital Postoperative Mortality Rates for Selected Procedures in Tanzania’s Lake Zone
title_sort in-hospital postoperative mortality rates for selected procedures in tanzania’s lake zone
topic Surgery in Low and Middle Income Countries
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7752880/
https://www.ncbi.nlm.nih.gov/pubmed/32995932
http://dx.doi.org/10.1007/s00268-020-05802-w
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