Determinants of morbidity and mortality following emergency abdominal surgery in children in lowincome and middle-income countries

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dc.contributor.authorAdemuyiwa, AO
dc.contributor.authorArnaud, AP
dc.contributor.authorDrake, TM
dc.contributor.authorFitzgerald, JEF
dc.contributor.authorPoenaru, D
dc.contributor.authorBhangu, A
dc.contributor.authorHarrison, EM
dc.contributor.authorGlasbey, J
dc.contributor.authorKhatri, C
dc.contributor.authorGobin, N
dc.contributor.authorFreitas, AV
dc.contributor.authoret, al
dc.date.accessioned2022-01-21T14:53:35Z
dc.date.available2022-01-21T14:53:35Z
dc.date.issued2016-12-12
dc.descriptionScholarly articlesen_US
dc.description.abstractBackground: 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.en_US
dc.identifier.citationGlobalSurg Collaborative. Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries. BMJ Glob Health. 2016 Dec 12;1(4):e000091. doi: 10.1136/bmjgh-2016-000091. Erratum in: BMJ Glob Health. 2017 Jan 30;2(1): PMID: 28588977; PMCID: PMC5321375.en_US
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/10663
dc.language.isoenen_US
dc.publisherBMJ Publisheren_US
dc.subjectAbdominal paediatric surgeryen_US
dc.subjectMortality risken_US
dc.subjectChildrenen_US
dc.subjectSurgeryen_US
dc.subjectResearch Subject Categories::MEDICINEen_US
dc.titleDeterminants of morbidity and mortality following emergency abdominal surgery in children in lowincome and middle-income countriesen_US
dc.typeArticleen_US
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