Management and Outcomes Following Surgery for Gastrointestinal Typhoid: An International, Prospective, Multicentre Cohort Study

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dc.contributor.authorAnyomih, TTK
dc.contributor.authorDrake, TM
dc.contributor.authorGlasbey, J
dc.contributor.authorFitzgerald, JE
dc.contributor.authorOts, R
dc.contributor.authorHarrison, EM
dc.contributor.authorTabiri, S
dc.contributor.authorBhangu, A
dc.contributor.authorAdemuyiwa, AO
dc.contributor.authorAguilera, ML
dc.contributor.authorAlexander, P
dc.contributor.authorAl-Saqqa, SW
dc.contributor.authorBorda-Luque, G
dc.contributor.authoret, al
dc.date.accessioned2022-08-30T13:52:18Z
dc.date.available2022-08-30T13:52:18Z
dc.date.issued2018-10
dc.descriptionScholarly articleen_US
dc.description.abstractBackground: Gastrointestinal perforation is the most serious complication of typhoid fever, with a high disease burden in low-income countries. Reliable, prospective, contemporary surgical outcome data are scarce in these settings. This study aimed to investigate surgical outcomes following surgery for intestinal typhoid. Methods: Two multicentre, international prospective cohort studies of consecutive patients undergoing surgery for gastrointestinal typhoid perforation were conducted. Outcomes were measured at 30 days and included mortality, surgical site infection, organ space infection and reintervention rate. Multilevel logistic regression models were used to adjust for clinically plausible explanatory variables. Effect estimates are expressed as odds ratios (ORs) alongside their corresponding 95% confidence intervals. Results: A total of 88 patients across the GlobalSurg 1 and GlobalSurg 2 studies were included, from 11 countries. Children comprised 38.6% (34/88) of included patients. Most patients (87/88) had intestinal perforation. The 30-day mortality rate was 9.1% (8/88), which was higher in children (14.7 vs. 5.6%). Surgical site infection was common, at 67.0% (59/88). Organ site infection was common, with 10.2% of patients affected. An ASA grade of III and above was a strong predictor of 30-day post-operative mortality, at the univariable level and following adjustment for explanatory variables (OR 15.82, 95% CI 1.53-163.57, p = 0.021). Conclusions: With high mortality and complication rates, outcomes from surgery for intestinal typhoid remain poor. Future studies in this area should focus on sustainable interventions which can reduce perioperative morbidity. At a policy level, improving these outcomes will require both surgical and public health system advances.en_US
dc.identifier.citationGlobalSurg Collaborative. Management and Outcomes Following Surgery for Gastrointestinal Typhoid: An International, Prospective, Multicentre Cohort Study. World J Surg. 2018 Oct;42(10):3179-3188. doi: 10.1007/s00268-018-4624-8. PMID: 29725797; PMCID: PMC6132852.en_US
dc.identifier.urihttps://ir.unilag.edu.ng/handle/123456789/11123
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.subjectGastrointestinal perforationen_US
dc.subjecttyphoid feveren_US
dc.subjectpatientsen_US
dc.subjectgastrointestinal typhoiden_US
dc.subjectResearch Subject Categories::MEDICINE::Surgeryen_US
dc.titleManagement and Outcomes Following Surgery for Gastrointestinal Typhoid: An International, Prospective, Multicentre Cohort Studyen_US
dc.typeArticleen_US
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