Changes in Surgical Volume and Outcomes During the Coronavirus Disease 2019 Pandemic at Two Tertiary Hospitals in Ethiopia: A Retrospective Cohort Study

ObjectiveThis study aimed to assess the incidence and identify predictors of perioperative mortality among the adult age group at Tibebe Ghion Specialised Hospital.DesignA single-centre prospective follow-up study.SettingA tertiary hospital in North West Ethiopia.ParticipantsWe enrolled 2530 participants who underwent surgery in the current study. All adults aged 18 and above were included except those with no telephone.Primary outcome measuresThe primary outcome was time to death measured in days from immediate postoperative time up to the 28th day following surgery.ResultA total of 2530 surgical cases were followed for 67 145 person-days. There were 92 deaths, with an incidence rate of 1.37 (95% CI 1.11 to 1.68) deaths per 1000 person-day observations. Regional anaesthesia was significantly associated with lower postoperative mortality (adjusted hazard ratio (AHR) 0.18, 95% CI 0.05 to 0.62). Patients aged ≥65 years (AHR 3.04, 95% CI 1.65 to 5.75), American Society of Anesthesiologist (ASA) physical status III (AHR 2.41, 95% CI 1.1.13 to 5.16) and IV (AHR 2.74, 95% CI 1.08 to 6.92), emergency surgery (AHR 1.85, 95% CI 1.02 to 3.36) and preoperative oxygen saturation <95% (AHR 3.14, 95% CI 1.85 to 5.33) were significantly associated with a higher risk of postoperative mortality.ConclusionThe postoperative mortality rate at Tibebe Ghion Specialised Hospital was high. Age ≥65, ASA physical status III and IV, emergency surgery, and preoperative oxygen saturation <95% were significant predictors of postoperative mortality. Patients with the identified predictors should be offered targeted treatment.

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“…All procedures performed in an operating room under the supervision of an anaesthesia provider for the specified time periods. 20 …”

Section: Methodsmentioning

confidence: 99%

Incidence and predictors of perioperative mortality in a low-resource country, Ethiopia: a prospective follow-up study

et al. 2023

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“…Considering this baseline, the situation was worsened by the COVID-19 pandemic. For example, a reduction in emergency and elective surgical volume was noted at several large referral surgical centers: Tikur Anbesa Specialized Hospital (TASH) (− 32% elective surgeries; − 19% emergency surgeries), and Ayder Comprehensive Specialized hospital (ACSH) and Tibebe Ghion Specialized Hospital (TGSH) (Combined) (− 80% elective surgeries; − 20% emergency surgeries) [ 23 , 24 ].…”

Section: Surgical Care In Ethiopia Pre-conflictmentioning

confidence: 99%

Organizational peer support to enable rehabilitating surgical services in Northern Ethiopia

et al. 2023

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The ongoing violent conflict in Northern Ethiopia has caused displacement, death, and destruction. Health services infrastructure became one of the primary victims of the war, leaving millions unable to access essential surgical health services at a time when demand for surgical interventions is on the rise. Rehabilitating surgical services was identified as a priority by the federal government, regional health bureaus, and humanitarian organizations, forming an integral part in rebuilding communities after war. Under the auspices of the Federal Ministry of Health of Ethiopia, a hospital twinning program between providers in non-conflict and conflict affected areas was first introduced in December 2021, now including 13 active partnerships. The program builds on a previous best practice gained from the Ethiopian Hospital Alliance for Quality to strengthen local health care providers in regaining capabilities to serve local populations. Field experience of two hospital twinning projects have shown significant scope of organizational peer support at times of crisis, successfully enabling conflict-afflicted hospitals to regain the capacity necessary to re-introduce surgical services. While overcoming challenges such as lack of basic supplies including electricity and blood may be required to further increase the scope of this program in Northern Ethiopia, relative success highlights important lessons for similar approaches in areas affected by conflict, or natural disasters.

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Capnography access and use in Kenya and Ethiopia

Nourian,

Alshibli,

Kamau

et al. 2023

Can J Anesth/J Can Anesth

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Changes in Surgical Volume and Outcomes During the Coronavirus Disease 2019 Pandemic at Two Tertiary Hospitals in Ethiopia: A Retrospective Cohort Study

Cited by 3 publications

References 30 publications

Incidence and predictors of perioperative mortality in a low-resource country, Ethiopia: a prospective follow-up study

Incidence and predictors of perioperative mortality in a low-resource country, Ethiopia: a prospective follow-up study

Organizational peer support to enable rehabilitating surgical services in Northern Ethiopia

Capnography access and use in Kenya and Ethiopia

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