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Br J Surg. 2016 Jul;103(8):971-988. doi: 10.1002/bjs.10151. Epub 2016 May 4.

Mortality of emergency abdominal surgery in high-, middle- and low-income countries.

Collaborators (1480)

Fitzgerald JEF, Khatri C, Glasbey JC, Mohan M, Lilford R, Harrison EM, Holmer H, Hall N, Kim SH, Negida A, Jaffry Z, Chapman SJ, Shu S, Shiwani H, Jeyakumar J, Fermani C, Balmaceda R, Marta Modolo M, Macdermid E, Gobin N, Chenn R, Ou Yong C, Edye M, Jarmin M, D'amours SK, Iyer D, Youssef D, Phillips N, Brown J, George R, Koh C, Warren O, Hanley I, Dickfos M, Nawara C, Öfner D, Primavesi F, Mitul AR, Mahmud K, Hussain M, Hakim H, Kumar T, Oosterkamp A, Assouto PA, Lawani I, Imorou Souaibou Y, Kyaw Tun A, Leung Chong C, Devadasar GH, Leung Chong C, Rashid Minhas Qadir M, Phyo Aung K, Shi Yeo L, Leung Chong C, Palomino Castillo VD, Moron Munhoz M, Moreira G, Barros De Castro Segundo LC, Anderson Khouri Ferreira S, Cassa Careta M, Binna Kim S, Venâncio De Sousa A, Daltri Lazzarini Cury A, Peixoto Soares Miguel G, Vega Carreiro De Freitas A, Pereira Silvestre B, Guasti Pinto Vianna J, Oliveira Felipe C, Alberto Valente Laufer L, Altoe F, Ayres Da Silva L, Pimenta ML, Fernandes Giuriato T, Alves Bezerra Morais P, Souza Luiz J, Araujo R, Menegussi J, Leal M, de Lima CVB, Sarmento Tatagiba L, Leal A, Vinicius Dos Santos D, Pereira Fraga G, Lages Simoes R, Stock S, Nigo S, Kabba J, Ebogo Ngwa T, Brown J, King S, Zani A, Azzie G, Firdouse M, Kushwaha S, Agarwal A, Bailey K, Cameron B, Livingston M, Horobjowsky A, Deckelbaum DL, Marinkovic TRB, Grasset E, D'aguzan N, Grasset E, Jimenez J, Macchiavello R, Zhang Z, Guo W, Oh J, Zheng F, Montes I, Sierra S, Mendez M, Villegas MI, Mendoza Arango MC, Mendoza I, Naranjo Aristizã Bal FA, Montoya Botero JA, Quintero Riaza VM, Restrepo J, Morales C, Mendoza Arango MC, Cruz H, Munera A, Mendoza Arango MC, Karlo R, Domini E, Mihanovic J, Radic M, Zamarin K, Pezelj N, Hache-Marliere M, Batista Lemaire S, Rivas R, Khyrallh A, Hassan A, Shimy G, Baky Fahmy MA, Nabawi A, Ali Muhammad Gohar MS, Elfil M, Ghoneem M, Asal M, Abdelkader M, Gomah M, Rashwan H, Karkeet M, Gomaa A, Hasan A, Elgebaly A, Azzam O, AbdelFattah A, Gouda A, Elshafay A, Gharib A, Menshawy A, Hanafy M, Al-Mallah A, Abdulgawad M, Baheeg M, Alhendy M, Fattah IA, Kenibar A, Osman O, Gemeah M, Mohammed A, Adel A, Gharib A, Mohammed A, Sayed A, Abozaid M, Hafez El-Badri Kotb A, Ahmed Ata AA, Nasr M, Alkammash A, Saeed M, Abd El Hamid N, Attia AM, Abd El Galeel A, Elbanby E, Salah El-Dien K, Hantour U, Alahmady O, Mansour B, Elkorashy AM, Saeed Taha EM, Lasheen KT, Said Elkolaly S, Yosri Elsayed Abdel-Wahab N, Fathi Abozyed MA, Adel A, Saeed AM, Samir El Sayed G, Youssif JH, Magdy Ahmed S, Soubhy El-Shahat N, Hegazy Khedr A, Osama Elsebaaye A, Elzayat M, Abdelraheim M, Elzayat I, Warda M, Naser El Deen K, Essam Elnemr A, Salah O, Abbas M, Rashad M, Elzayyat I, Hemeda D, Tawfik G, Salama M, Khaled H, Seisa M, Elshaer K, Hussein A, Elkhadrawi M, Afifi AM, Saadeldeen Ebrahim O, Metwally MM, Elmelegy R, Elbendary Elsawahly DM, Safa H, Nofal E, Elbermawy M, Abo Raya M, Abdelmotaleb Ghazy A, Samih H, Abdelgelil A, Abdelghany S, El Kholy A, Elkady F, Salma M, Samy S, Fakher R, Aboarab A, Samir A, Sakr A, Haroun A, Abdel-Rahman Al-Aarag A, Elkholy A, Elshanwany S, Ghanem E, Tammam A, Hammad AM, El Shoura Y, El Ashal G, Khairy H, Antar S, Mehrez S, Abdelshafy M, Gamal Mohamad Hamad M, Farid Hosh M, Abdallah E, Magdy B, Alzayat T, Gamaly E, Elfeki H, Abouzahra A, Elsheikh S, Elgendy F, Abd El-Salam F, Seifelnasr O, Ammar M, Eysa A, Sadek A, Gamal Toeema A, Shady K, Nasr A, Abuseif M, Zidan H, Abd Elmageed Barakat S, Elsayed N, Abd Elrasoul Y, Elkelany A, Sabry Ammar M, Mustafa M, Hegazy Y, Etman M, Saad S, Alrahawy M, Raslan A, Morsi M, Rslan A, Sabry A, Elwakil H, Shaker H, Zidan H, Abd-Elrasoul Y, Elkelany A, El-Kashef H, Shaalan M, Tarek A, Elwan A, Ragab Nayel A, Seif M, Emadeldin D, Ali Ghonaim M, Almallah A, Fouad A, Adel Sayma E, Elbatahgy A, Solaiman El-Ma'doul A, Mosad A, Tolba H, Amin Elsorogy DA, Ali Mostafa H, Atef Omar A, Sherief Abd El Hameed O, Lasheen A, Abd El Salam Y, Morsi A, Ismail M, Ahmed El-Badawy H, Amer M, Elkelany A, Elkelany A, Sabry El-Hamouly A, Ahmed Attallah N, Mosalum O, Afandy A, Mokhtar A, Abouelnasr A, Ayad S, Shaker R, Sakr R, Shaker R, Amreia M, Elsobky S, Mustafa M, Abo El Magd A, Marey A, Tarek Hafez A, Zalabia M, Moamen Mohamed M, Fadel A, Ali Ahmed E, Ali A, Ghassan Alwafai M, Dwydar A, Kharsa S, Mamdouh E, El-Sheemy H, Youssef I, Khairy Aly A, Aldalaq A, Alnawam E, Alkhabbaz D, Saad M, Hussein S, Abo Elazayem A, Ramadan A, Elashmawy M, Mousa M, Nashaat A, Ghanem S, Oof Z, Elwaey A, Elkadsh I, Darweesh M, Mohameden A, Hafez M, Badr A, Badwy A, Abd El Slam M, Elazoul M, Al-Nahrawi S, Eldamaty L, Nada F, Ameen M, Hagar A, Elsehimy M, Aboraya M, Dawoud H, El Mesery S, El Gendy A, Abdelkareem A, Safwan Marey A, Allam M, Shehata S, Abozeid K, Elshobary M, Fahiem A, Sarsik S, Hashish A, Zidan M, Hashish M, Sanad A, Mesalam M, Aql S, Osman Abdelaziz Elhendawy A, Husseini M, Kasem E, Gheith A, Elfouly Y, Ragab Soliman A, Ibrahim Y, Elfouly N, Fawzy A, Hassan A, Rashid M, Salah Elsherbiny A, Sieda B, Badwi N, Hassan Mohammed MM, Mohamed O, Abdulkhalek Habeeb M, Worku M, Starr N, Desta S, Wondimu S, Abebe NS, Thomas E, Asele FA, Dabessa D, Seyoum Abebe N, Zerihun AB, Mentula P, Leppäniemi A, Sallinen V, Scalabre A, Frade F, Irtan S, Graffeille V, Gaignard E, Alimi Q, Alimi Q, Graffieille V, Gaignard E, Abbo O, Mouttalib S, Bouali O, Hervieux E, Aigrain Y, Botto N, Faure A, Fievet L, Panait N, Eyssartier E, Schmitt F, Podevin G, Parent V, Martin A, Arnaud AP, Muller C, Bonnard A, Peycelon M, Abantanga F, Boakye-Yiadom K, Bukari M, Owusu F, Awuku-Asabre J, Tabiri S, Bray LD, Lytras D, Psarianos K, Bamicha A, Kefalidi E, Gemenetzis G, Dervenis C, Gouvas N, Agalianos C, Kontos M, Kouraklis G, Karousos D, Germanos S, Marinos C, Anthoulakis C, Nikoloudis N, Mitroudis NS, Recinos G, Estupinian S, Forno W, Arévalo Azmitia JR, Ramã Rez Cabrera CC, Guevara R, Aguilera M, Mendez N, Azmitia Mendizabal CA, Ramazzini P, Contreras Urquizu M, Tale F, Soley R, Barrios E, Barrios E, Marroquín Rodríguez DE, Pérez Velásquez CI, Contreras Mérida SM, Regalado F, Lopez M, Siguantay M, Lam FY, Szeto KJ, Szeto CCL, Li WS, Li KKK, Leung MF, Mak T, Ng S, Prasad SS, Kirishnan A, Gyanchandani N, Bhat S, Sreedharan A, Kinnera SV, Kumar BS, Rangarajan M, Reddy Y, Venugopal C, Kumar S, Mittal A, Nadkarni S, Lakshmi HN, Malik P, Limaye N, Pai S, Jain P, Khajanchi M, Satoskar S, Satoskar R, Mahamood AB, Refianti Sutanto EP, Soeselo DA, Tedjaatmadja C, Rahmawati FN, Amandito R, Mayasari M, Jawad Al-Hasani RKM, Ibraheem Al-Hameedi HI, Aziz Al-Azraqi IA, Sabeeh L, Kamil R, Shawki M, Mezeil Telfah M, Rasendran A, Sheehan J, Kerley R, Normile C, Gilbert RW, Song J, Dablouk M, Mauro L, Dablouk MO, Hanrahan M, Kielty P, Marks E, Gosling S, Mccarthy M, Rasendran A, Mirghani D, Altaf Naqvi S, Wong CS, Chung S, D'cruz R, Cahill R, Gosling SG, Mccarthy M, Rasendran A, Fahy C, Song J, Hanrahan M, Duarte Cadogan D, Powell A, Gilbert R, Clifford C, Normile C, Driscoll A, Stassen P, Lee C, Bowe R, Hutch W, Hanrahan M, Mohan H, O'Neill M, Mealy K, Danelli P, Bondurri A, Maffioli A, Pasini M, Pata G, Roncali S, Silvani P, Carlucci M, Faccincani R, Bonavina L, Macchitella Y, Ceriani C, Tugnoli G, Di Saverio S, Khattab K, Angel Paludi M, Pata D, Maria Cloro L, Allegri A, Ansaloni L, Coccolini F, Veronese E, Bortolasi L, Hasheminia A, Nastri G, Dal Canto M, Cucumazzo S, Pata F, Benevento A, Tessera G, Paolo Grandinetti P, Maniscalco A, Luca Lamanna G, Turati L, Sgroi G, Rausa E, Villa R, Monteleone M, Merlini D, Grassi V, Cirocchi R, Cacurri A, Waleed H, Diab A, Elzowawi F, Jokubauskas M, Varkalys K, Venskutonis D, Pranevicius R, Ambrozeviciute V, Juciute S, Skardžiukaitė A, Venskutonis D, Bradulskis S, Urbanavicius L, Austraite A, Riauka R, Zilinskas J, Dambrauskas Z, Karumnas P, Urniezius Z, Zilinskiene R, Rudzenskaite A, Usaityte A, Montrimaite M, Kaselis N, Strazdas A, Jokubonis K, Maceviciute K, Laugzemys E, Kolosov A, Jotautas V, Rakita I, Mikalauskas S, Kazanavicius D, Rackauskas R, Strupas K, Poskus T, Beisa V, Rakauskas R, Preckailaite E, Coomber R, Johnson K, Nowers J, Periasammy D, Salleh A, Das A, Goh Ern Tze R, Nirumal Kumar M, Nik Abdullah NA, Kosai NR, Taher M, Rajan R, Chong HY, Roslani AC, Goh CC, Agius M, Borg E, Bezzina M, Bugeja R, Vella-Baldacchino M, Spina A, Psaila J, Francois-Coridon H, Tolg C, Colombani JF, Diaz-Zorrilla C, Ramos-De La Medina A, Corro-Diaz Gonzalez S, Jacobe M, Mapasse D, Snyder E, Oumer R, Osman M, Mohammad A, Anyanwu LJ, Sheshe A, Adesina A, Faturoti O, Taiwo O, Habib Ibrahim M, Nasir AA, Itopa Suleiman S, Adeniyi A, Adesanya O, Adebanjo A, Osuoji R, Atobatele K, Ogunyemi A, Wiliams O, Oludara M, Oshodi O, Ademuyiwa A, Oluwagbemiga Lawal A, Alakaloko F, Elebute O, Osinowo A, Bode C, Adesuyi A, Tade A, Adekoya A, Nwokoro C, Ayandipo OO, Akeem Lawal T, Ajao AE, Sani Ali S, Odeyemi B, Olori S, Popoola A, Adeyeye A, Adeniran J, Lossius WJ, Havemann I, Thorsen K, Narvestad JK, Søreide K, Wold TB, Nymo L, Elsiddig M, Dar M, Bhopal KF, Iftikhar Z, Furqan MM, Nighat B, Jawaid M, Khalique A, Zil-E-Ali A, Rashid A, Abbas Dharamshi H, Naqvi T, Faraz A, Anwar AW, Muhammad Yaseen T, Shamsi GS, Yaseen T, Anwer W, Paredes Decoud H, Aguilera O, Zelada Alvarez II, Marcelo Delgado J, Machain Vega GM, Segovia Lohse HA, Messa Aguilar WL, Cabala Chiong JA, Manchego Bautista AC, Huaman E, Zegarra S, Camacho R, Vergara Celis JM, Romani Pozo DA, Hamasaki J, Temoche E, Herrera-Matta J, García Torres CP, Alvarez Barreda LM, Barrionuevo Ojeda R, Garaycochea O, Castro Mollo M, Linares Delgado M, Fujii F, Manchego Bautista AC, Messa Aguilar WL, Cabala Chiong JA, Durand SA, Arroyo Basto CA, Urbina Rojas NM, Shu Yip SB, Contreras Vergara AL, Echevarria Rosas Moran A, Borda Luque G, Rodriguez Castro M, Alvarado Jaramillo R, Manrique Sila G, Lopez CE, Zapata Ponze De Leon M, Machaca M, Coasaca Huaraya R, Arenas A, López C, Milagros Herrera Puma C, Pino W, Hinojosa C, Zapata Ponze De Leon M, Limache S, Manrrique Sila G, Mercado Rodriguez LA, Melo R, Costa-Maia J, Muralha N, Sauvat F, Dan I, Hogea M, Eduard P, Bratu RM, Beuran M, Diaconescu IB, Martian BV, Iordache FM, Vartic M, Vida LC, Muntean LI, Mironescu AS, Nsengimana VJP, Niragire A, Allen Ingabire JDLC, Niyirera E, Zanini N, Jovine E, Landolfo G, Alomar IN, Alnuqaydan SA, Altwigry AM, Othman M, Osman N, Alqahtani E, Alzahrani M, Alyami R, Aljohani E, Alhabli I, Mikwar Z, Almuallem S, Aljohani E, Alyami R, Alzahrani M, Nawawi A, Bakhaidar M, Maghrabi AA, Alsaggaf M, Aljiffry M, Altaf A, Khoja A, Habeebullah A, Akeel N, Ghandora N, Almoflihi A, Huwait A, Al-Shammari A, Al-Mousa M, Alghamdi M, Adham W, Albeladi B, Alfarsi MA, Mahdi A, Al Awwad S, Altamimi A, Nouh T, Hassanain M, Aldhafeeri S, Sadig N, Algohary O, Aledrisy M, Gudal A, Alrifaie A, AlRowais M, Althwainy A, Shabkah A, Alamoudi U, Alrajraji M, Alghamdi B, Aljohani S, Daqeeq A, Al-Faifi JJ, Jennings V, Ngayu N, Moore R, Kong V, Kretzmann H, Connor K, Nel D, Sampson C, Spence R, Panieri E, Rayne S, Sishuba N, Tun M, Mphatsoe AM, Carreira JA, Teasdale E, Wagener M, Botes S, Du Plessis D, Fernandez-Bueno F, Aguilar-Jimenez J, Garcia-Marin JA, García LS, García Florez LJ, Darío Arias Pacheco R, Pagnozzi J, Jara Quezada JH, Rodicio JL, Minguez G, Rodríguez-Uría R, Ugalde P, Lopez-Arevalo C, Barneo L, Gonzales Stuva JP, Ortega-Vazquez I, Rodriguez L, Herrera N, Pitigala Arachchi P, Kithsiri Janakantha Senanayake WSM, Jayasooriya Arachchige LAJ, Sivaganesh S, Samaraweera DI, Thanusan V, Musa AEK, Balila RMH, Mohamed MAEH, Ali H, Zain Elabdin H, Hassan A, Mahdi S, Ahmed H, Abdoun Ishag Idris S, Elsayed M, Elsayed M, Mahmoud M, Boijsen M, Lundgren PO, Gustafsson U, Kiasat A, Wogensen F, Wogensen F, Jurdell E, Thorell A, Thorarinsdottir H, Utter M, Sundstrom SM, Wredberg C, Kjellin A, Nyberg J, Frisk B, Sund M, Andersson L, Gunnarsson U, Cengiz Y, Ahlqvist S, Björklund I, Royson H, Weber P, Pahlsson HI, Borin E, Hjertberg M, Royson H, Weber P, Schmid R, Schivo D, Despotidis V, Breitenstein S, Staerkle RF, Schadde E, Deichsel F, Gerosa A, Nocito A, Raptis DA, Mijuskovic B, Zuber M, Eisner L, Kruspi S, Reinisch KB, Schoewe C, Novak A, Palma AF, Teufelberger G, Kimaro M, King R, Balkan AZA, Gumar M, Ali Yavuz M, Karabacak U, Lap G, Ozkan BB, Ozkan BB, Karakahya M, Adams R, Morton R, Henderson L, Gratton R, Clement KD, Yu-Ching Chang K, Mcnish D, Mcintosh R, Milligan W, Skelly B, Anderson-Knight H, Lawther R, Onimowo J, Shatkar V, Tharmalingam S, Woin E, Fautz T, Ziff O, Dindyal S, Talukder S, Arman S, Gadhvi V, Talukder S, Chew LS, Heath J, Blencowe N, Hallam S, Gash K, Singh Mannu G, Zachariades DC, Snaith AC, Hettiarachchi TS, Nesaratnam A, Wheeler J, McCullagh D, Clements JM, Khan A, Koumpa F, Neophytou C, Roth J, Soon WC, Deputy M, Ahmed A, Ashton A, Vincent J, Almy J, Khan T, Allen JLY, Mcintyre CJ, Marshall DC, Sykes M, Behar N, Jordan H, Rajjoub Y, Sherman T, White T, Watts A, Ardley R, Arulampalam T, Shah A, Brown D, Blower E, Sutton P, Gasteratos K, Vimalachandran D, Magee C, Irwin G, Mcguigan A, Mcaleer S, Morgan C, Braungart S, Lafferty K, Labib P, Tanase A, Mangan C, Reza L, Tanase A, Mangan C, Woodward H, Gouldthorpe C, Turner M, Wild JRL, Malik TAM, Proctor VK, Hewage K, Davies J, Dubois A, Sarwary S, Zardab A, Grant A, Mcintyre R, Mogan YP, Ho W, Hon Khi Chong BF, Tewari S, Humm G, Farinella E, Hall NJ, Wright NJ, Major CP, Xerri T, De Bono P, Amin J, Farhad M, Camilleri-Brennan JF, Robertson AGN, Swann J, Richards J, Jabbar A, Attard M, Burns H, Macdonald E, Baldacchino M, Skehan J, Camilleri-Brennan J, Falconer Hall T, Gimzewska M, Mclachlan G, Shah J, Giles J, Chiu S, Weber B, Man Yeng Chiu S, Highcock S, Hassan M, Beasley W, Vlachogiorgos A, Dias S, Maharaj G, Mcdonald R, Macdonald A, Witherspoon P, Baird A, Sarmah P, Green N, Youssef H, Cross K, Rees CM, Van Duren B, Upchurch E, Khan K, Abudeeb H, Hammad A, Karandikar S, Bowley D, Karim A, Chachulski W, Richardson L, Dawnay G, Thompson B, Mistry A, Bhangu A, Ghetia M, Roy S, Al-Obaedi O, Ghetia M, Das K, Prabhudesai A, Cocker DM, Tan JJ, Tyler R, Di Franco F, Ayyar S, Vivekanantham S, Gokani S, Gillespie M, Gudlaugsdottir K, Pezas T, Currow C, Young-Han Kim M, Birring A, Edwards J, Ali A, Das S, Jha M, Atkinson K, Luck J, Fozard T, Puttick M, Salama Y, Shah R, Ibrahem AA, Ebdewi H, Gravante G, El-Rabaa S, Nnajiuba H, Allott R, Bhargava A, Chan Z, Hassan Z, Makinde M, Hemingway D, Dean R, Boddy A, Aber A, Patel V, Parakh J, Parthiban S, Ubhi HK, Hosein SP, Ward S, Malik K, Jennings L, Newton T, Alkhouri M, Kang MK, Houlden C, Barry J, Raza I, Farquharson A, Bhattacharya S, Milligan W, Chang K, Henderson L, Wilson MSJ, Neo YN, Ibrahim I, Chan E, Peck FS, Lim PJ, North AS, Blundell R, Williamson A, Fouad D, Minocha A, Mccarthy K, Court E, Chambers A, Yee J, Tham JC, Beaton C, Walsh U, Lockey J, Bokhari S, Howells L, Griffiths M, Yallop L, Singh S, Nasher O, Jackson P, Puttick M, Luck J, Fozard T, Shariffuddin AM, Ho WC, Wilson MSJ, Pabla G, Ramzi S, 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Erratum in

Abstract

BACKGROUND:

Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).

METHODS:

This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.

RESULTS:

Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1·6 per cent at 24 h (high 1·1 per cent, middle 1·9 per cent, low 3·4 per cent; P < 0·001), increasing to 5·4 per cent by 30 days (high 4·5 per cent, middle 6·0 per cent, low 8·6 per cent; P < 0·001). Of the 578 patients who died, 404 (69·9 per cent) did so between 24 h and 30 days following surgery (high 74·2 per cent, middle 68·8 per cent, low 60·5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2·78, 95 per cent c.i. 1·84 to 4·20) and low-income (OR 2·97, 1·84 to 4·81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days.

CONCLUSION:

Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role.

REGISTRATION NUMBER:

NCT02179112 (http://www.clinicaltrials.gov).

PMID:
27145169
DOI:
10.1002/bjs.10151
[Indexed for MEDLINE]

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