Nigerian surgical outcomes - Report of a 7-day prospective cohort study and external validation of the African surgical outcomes study surgical risk calculator

被引:18
|
作者
Osinaike, Babatunde [1 ,91 ]
Ayandipo, Omobolaji [2 ,91 ]
Onyeka, Tonia [3 ,55 ]
Alagbe-Briggs, Olubusola [4 ,98 ]
Mohammed, Alhassan [5 ,67 ]
Oyedepo, Olanrewaju [6 ,75 ]
Nuhu, Ahmed [7 ,48 ,103 ]
Asudo, Felicia [8 ]
Akanmu, Olanrewaju [9 ]
Nwokorie, Chris [10 ]
Mohammed, Abdulrahman [11 ]
Edubio, Mark [12 ]
Izuora, Kodilinye [13 ,42 ]
Mohammed, Rabiu [14 ,43 ,65 ]
Nweze, Onochie [15 ,45 ]
Efu, Michael [16 ,47 ]
Eguma, Stella [17 ,49 ]
Jasper, Abiodun [18 ,51 ]
Ewah, Richard [19 ,52 ]
Akhideno, Irene [20 ]
Nnaji, Chimaobi [21 ,60 ]
Ado, Suleiman [22 ]
Ogboli-Nwasor, Elizabeth [23 ,65 ]
Atiku, Mamuda [5 ,67 ]
Salisu, Ibrahim [24 ,70 ]
Adinoyi, Yakubu [25 ,72 ]
Agu, Edith [26 ,73 ]
Desalu, Ibironke [27 ,76 ]
Samuel, Luka [28 ]
Olorode, Yunus [29 ]
Fatungase, Oluwabunmi [30 ,83 ]
Akinwonmi, Olugbenga [31 ,87 ,88 ]
Faponle, Folayemi [32 ,89 ]
Idowu, Olusola [33 ,91 ]
Isamade, Erdoo [34 ]
Aliyu, Abdulrahman [35 ,100 ]
Hamza, Garba [36 ,104 ]
Onajin-Obembe, Bisola [37 ,98 ]
Amanor-Boadu, Simbo [1 ,38 ]
Buba, Shanka [1 ,4 ,101 ,102 ]
Okereke, Uzochukwu [39 ]
Nwajagu, Chukwudi [39 ]
Okereke, Nneka [39 ]
Michael, Bankohere [40 ]
Polycarp, Justina [40 ]
Oyinloye, Adewale [40 ]
Adediran, Adekola [40 ]
Murey, Bartholomew [40 ]
Oyebanji, Lateef [40 ]
Jomosu, Cyril [40 ]
机构
[1] Univ Ibadan, Dept Anaesthesia, Univ Coll Hosp, PMB 5116, Ibadan, Oyo State, Nigeria
[2] Univ Ibadan, Dept Surg, Univ Coll Hosp, Ibadan, Oyo State, Nigeria
[3] Univ Nigeria, Dept Anaesthesia, Teaching Hosp, Enugu, Enugu State, Nigeria
[4] Univ Port Harcourt, Dept Anaesthesia, Teaching Hosp, Port Harcourt, Rivers State, Nigeria
[5] Aminu Kano Univ, Dept Anaesthesia, Teaching Hosp, Kano, Kano State, Nigeria
[6] Univ Ilorin, Dept Anaesthesia, Teaching Hosp, Ilorin, Kwara State, Nigeria
[7] Univ Maiduguri, Dept Anaesthesia, Teaching Hosp, Maiduguri, Borno State, Nigeria
[8] Univ Abuja, Dept Anaesthesia, Teaching Hosp, Gwagwalada, Abuja, Nigeria
[9] Univ Lagos, Dept Anaesthesia, Teaching Hosp, Lagos, Lagos State, Nigeria
[10] Fed Med Ctr, Dept Anaesthesia, Umahia, Abia State, Nigeria
[11] Fed Med Ctr, Dept Anaesthesia, Yola, Adamawa State, Nigeria
[12] Univ Uyo, Dept Anaesthesia, Teaching Hosp, Uyo, Akwa Ibom State, Nigeria
[13] Nnamdi Azikwe Univ, Dept Anaesthesia, Teaching Hosp, Nnewi, Anambra State, Nigeria
[14] Abubakar Tafawa Balewa Univ, Dept Anaesthesia, Teaching Hosp, Bauchi, Bauchi State, Nigeria
[15] Fed Med Ctr, Dept Anaesthesia, Yenegoa, Bayelsa State, Nigeria
[16] Benue State Univ, Dept Anaesthesia, Teaching Hosp, Makurdi, Benue State, Nigeria
[17] Univ Calabar, Dept Anaesthesia, Teaching Hosp, Calabar, Cross River Sta, Nigeria
[18] Delta State Univ, Dept Anaesthesia, Teaching Hosp, Oghara, Delta State, Nigeria
[19] Fed Teaching Hosp, Dept Anaesthesia, Abakaliki, Ebonyi State, Nigeria
[20] Irrua Specialist Hosp, Dept Anaesthesia, Irrua, Edo State, Nigeria
[21] Fed Med Ctr, Dept Anaesthesia, Owerri, Imo State, Nigeria
[22] Rasheed Sekoni Teaching Hosp, Dept Anaesthesia, Dutse, Jigawa State, Nigeria
[23] Ahmadu Bello Univ, Dept Anaesthesia, Teaching Hosp, Zaria, Kaduna State, Nigeria
[24] Fed Med Ctr, Dept Anaesthesia, Katsina, Katsina State, Nigeria
[25] Fed Med Ctr, Dept Anaesthesia, Birnin Kebbi, Kebbi State, Nigeria
[26] Fed Med Ctr, Dept Anaesthesia, Lokoja, Kogi State, Nigeria
[27] Lagos Univ, Dept Anaesthesia, Teaching Hosp, Idi Araba, Lagos State, Nigeria
[28] Fed Med Ctr, Dept Anaesthesia, Keffi, Nasarawa, Nigeria
[29] Fed Med Ctr, Dept Anaesthesia, Bida, Niger State, Nigeria
[30] Olabisi Onabanjo Univ, Dept Anaesthesia, Teaching Hosp, Shagamu, Ogun State, Nigeria
[31] Fed Med Ctr, Dept Anaesthesia, Owo, Ondo State, Nigeria
[32] Obafemi Awolowo Univ, Dept Anaesthesia, Teaching Hosp, Ife, Osun State, Nigeria
[33] UniUniv Coll Hosp, Dept Anaesthesia, Ibadan, Oyo State, Nigeria
[34] Jos Univ Teaching Hosp, Dept Anaesthesia, Jos, Plateau State, Nigeria
[35] Uthman Dan Fodio Univ, Dept Anaesthesia, Teaching Hosp, Sokoto, Sokoto State, Nigeria
[36] Fed Med Ctr, Dept Anaesthesia, Jalingo, Taraba State, Nigeria
[37] Fed Med Ctr, Dept Anaesthesia, Gusau, Zamfara State, Nigeria
[38] Univ Port Harcourt, Dept Anaesthesia, Port Hartcourt, Rivers State, Nigeria
[39] Fed Med Ctr, Umuahia, Nigeria
[40] Fed Med Ctr, Yola, Nigeria
[41] New Boshang Hosp Ltd, Yola, Nigeria
[42] Nnamdi Azikiwe Univ, Teaching Hosp, Nnewi, Nigeria
[43] Abubakar Tafawa Balewa Univ, Teaching Hosp, Bauchi, Nigeria
[44] Bauchi State Specialist Hosp, Bauchi, Nigeria
[45] Fed Med Ctr, Yenagoa, Nigeria
[46] Niger Delta Univ, Teaching Hosp, Yenagoa, Olokobiri, Nigeria
[47] Benue State Univ, Teaching Hosp, Makurdi, Nigeria
[48] Univ Maiduguri, Teaching Hosp, Maiduguri, Nigeria
[49] Univ Calabar, Teaching Hosp, Calabar, Nigeria
[50] Cent Hosp, Warri, Nigeria
关键词
Failure-to-rescue; Postoperative care; Surgical outcomes; Surgical risk calculator; PERIOPERATIVE MORTALITY-RATE; CRITICAL-CARE; LOW-INCOME; PATIENT OUTCOMES; SURGERY; COMPLICATIONS; MORBIDITY; COUNTRIES; SERVICES; BURDEN;
D O I
10.1016/j.ijsu.2019.06.003
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Surgical outcomes study for individual nations remains important because of international differences in patterns of surgical disease. We aimed to contribute to data on post-operative complications, critical care admissions and mortality following elective surgery in Nigeria and also validate the African Surgical Outcomes Study (ASOS) surgical risk calculator in our adult patient cohort. Materials and methods: We conducted a 7-day, national prospective observational cohort study in consented consecutive patients undergoing elective surgery with a planned overnight hospital stay following elective surgery during a seven-day study period. The outcome measures were in-hospital postoperative complications, critical care admissions and in-hospital mortality censored at 30 days. Also, we identified variables which significantly contributed to higher ASOS surgical risk score. External validation was performed using area under the receiver operating characteristic curve (ROC) for discrimination assessment and Hosmer-Lemeshow test for calibration. Results: A total of 1,425 patients from 79 hospitals participated in the study. Postoperative complications occurred in 264(18.5%, 95% CI 16.6-20.6), 20(7.6%) of whom were admitted into the ICU and 16(6.0%) did not survive. Total ICU admission was 57 (4%), with mortality rate of 23.5% following planned admission and overall in-hospital death was 22(1.5%, 95% CI 0.9-2.2). All prognostic factors in the ASOS risk calculator were significantly associated with higher ASOS score and the scoring system showed moderate discrimination (0.73, 95% CI 0.62-0.83). Hosmer-Lemeshow X-2 test revealed scale was well calibrated in the validation cohort. Conclusion: NiSOS validates the findings of ASOS and the ability of the ASOS surgical risk calculator to predict risk of developing severe postoperative complications and mortality. We identified failure-to-rescue as a problem in Nigeria. Furthermore, this study has provided policy makers with benchmarks that can be used to monitor programmes aimed at reducing the morbidity and mortality after elective surgery. We recommend the adoption of the ASOS surgical risk calculator as a tool for risk stratification preoperatively for elective surgery.
引用
收藏
页码:148 / 156
页数:9
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