Emergency‐to‐Elective Surgery Ratio: A Global Indicator of Access to Surgical Care

Prin, Meghan; Guglielminotti, Jean; Mtalimanja, Onias; Li, Guohua; Charles, Anthony

doi:10.1007/s00268-017-4415-7

Cited by 43 publications

(35 citation statements)

References 69 publications

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“…20 The majority of amputations involved LL and, as explained above, limbs were highly compromised, there was a higher number of urgent treatments. On this issue, a study by Prin et al 21 showed the extent to which the proportions of urgent and elective surgeries are disproportionate in different parts of the world, such as sub-Saharan Africa, the United States, and Europe. Developing countries have many more difficulties with access to healthcare, whereas in high income nations care is better and the numbers of emergency surgeries are much lower.…”

Section: Discussionmentioning

confidence: 99%

Caracterização das pessoas amputadas de um hospital de grande porte em Recife (PE, Brasil)

2019

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Resumo Contexto A amputação de membros pode ser definida como um procedimento que consiste em separar do corpo um membro ou segmento dele. Objetivos Descrever o perfil dos procedimentos de amputações de membros realizados em um hospital estadual de grande porte. Métodos Estudo transversal do tipo descritivo e retrospectivo realizado em um hospital de grande porte da cidade de Recife (PE). Os dados foram coletados em registros de pacientes que foram submetidos à amputação no ano de 2017. Foram incluídos pacientes que tiveram seu membro amputado em 2017 e excluídos aqueles com informações ilegíveis ou incompletas. Resultados Foram realizados 328 procedimentos em 274 pacientes, a maioria do gênero masculino (57,7%). Houve predominância de amputações em membros inferiores (64,2%), de causa não traumática (86,5%) e atendimentos de urgência (96,4%). A maioria dos pacientes submetidos a amputações ficaram internados por um período de 11 a 25 dias (32,1%). Este estudo mostrou que a maioria das pessoas amputadas recebeu alta (69,7%) e uma parte foi a óbito, sendo os óbitos, no caso das amputações de membros inferiores, principalmente de pessoas idosas na faixa etária de 60 a 90 anos (76%), do sexo feminino (55%), e submetidas a uma amputação (91%). Conclusões Os dados apresentados neste estudo são alarmantes, principalmente ao se considerar que muitas das amputações poderiam ter sido evitadas, visto que foram decorrentes de complicações de doenças cuja prevenção e controle podem ser realizados em outros níveis de complexidade do sistema e com custo relativamente baixo.

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Section: Discussionmentioning

confidence: 99%

Caracterização das pessoas amputadas de um hospital de grande porte em Recife (PE, Brasil)

2019

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“…This is due to the largest portion of the surgical volume in developing countries cannot be postponed safely due to their urgent and emergent nature. [ 33 ] Another major challenge that we did not face until now is the shortage of intensive care (ICU) beds. [ 30 ] Even if the ICU beds are abundant, there will be a significant shortage of supplies such as ventilators and oxygen, and all of the other supplies required for severe respiratory failure patients’ care.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Soliman

Elbaroody

Elsamman

et al. 2020

Surgical Neurology International

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Background: Although primarily a respiratory disorder, the coronavirus pandemic has paralyzed almost all aspects of health-care delivery. Emergency procedures are likely continuing in most countries, however, some of them raises certain concerns to the surgeons such as the endoscopic endonasal skull base surgeries. The aim of this study is to present the current situation from a developing country perspective in dealing with such cases at the time of the COVID-19 pandemic. Methods: A cross-sectional analytical survey was distributed among neurosurgeons who performed emergency surgeries during the COVID-19 pandemic in Cairo, Egypt, between May 8, 2020, and June 7, 2020. The survey entailed patients’ information (demographics, preoperative screening, and postoperative COVID-19 symptoms), surgical team information (demographics and postoperative COVID-19 symptoms), and operative information (personal protective equipment [PPE] utilization and basal craniectomy). Results: Our survey was completed on June 7, 2020 (16 completed, 100% response rate). The patients were screened for COVID-19 preoperatively through complete blood cell (CBC) (100%), computed tomography (CT) chest (68.8%), chest examination (50%), C-reactive protein (CRP) (50%), and serological testing (6.3%). Only 18.8% of the surgical team utilized N95 mask and goggles, 12.5% utilized face shield, and none used PAPRs. Regarding the basal craniectomy, 81.3% used Kerrison Rongeur and chisel, 25% used a high-speed drill, and 6.3% used a mucosal shaver. None of the patients developed any COVID-19 symptoms during the first 3 weeks postsurgery and one of the surgeons developed high fever with negative nasopharyngeal swabs. Conclusion: In developing countries with limited resources, preoperative screening using chest examination, CBC, and CT chest might be sufficient to replace Reverse transcription polymerase chain reaction. Developing countries require adequate support with screening tests, PPE, and critical care equipment such as ventilators.

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“…Comparing elective and emergency surgery, where emergency patients are more complex [ 15 ], Prin et al [ 20 ] show that in developed countries, less than one emergency surgery is performed for every ten elective surgeries. In addition, timely and effective elective surgery might reduce the need for emergency services [ 20 ]. Therefore, an efficient operational model for treating routine patients is central to curbing healthcare costs while delivering high-quality care.…”

Section: Introductionmentioning

confidence: 99%

Does Focus Improve Performance in Elective Surgery? A Study of Obesity Surgery in Sweden

Svarts

Urciuoli

Thorell

et al. 2020

IJERPH

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Recent studies have found positive effects from hospital focus on both quality and cost. Some studies indicate that certain patient segments benefit from focus, while others have worse outcomes in focused hospital departments. The aim of this study was to establish the relationship between hospital focus and performance in elective surgery. We studied obesity surgery procedures performed in Sweden in 2016 (5152 patients), using data from the Scandinavian Obesity Surgery Registry (SOReg) complemented by a survey of all clinics that performed obesity surgery. We examined focus at two levels of the organization: hospital level and department level. We hypothesized that higher proportions of obesity surgery patients in the hospital, and higher proportions of obesity surgery procedures in the department, would be associated with better performance. These hypotheses were tested using multilevel regression analysis, while controlling for patient characteristics and procedural volume. We found that focus was associated with improved outcomes in terms of reduced complications and shorter procedure times. These positive relationships were present at both hospital and department level, but the effect was larger at the department level. The findings imply that focus is a viable strategy to improve quality and reduce costs for patients undergoing elective surgery. For these patients, general hospitals should consider implementing organizationally separate units for patients undergoing elective surgery.

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Emergency‐to‐Elective Surgery Ratio: A Global Indicator of Access to Surgical Care

Abstract: The Ee ratio appears to be a simple and valid indicator of access to available surgical care. Global health efforts may focus on investment in low-resource settings to improve access to available surgical care.

Cited by 43 publications

References 69 publications

Caracterização das pessoas amputadas de um hospital de grande porte em Recife (PE, Brasil)

Caracterização das pessoas amputadas de um hospital de grande porte em Recife (PE, Brasil)

Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Does Focus Improve Performance in Elective Surgery? A Study of Obesity Surgery in Sweden

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