Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study

Abstract

Medical Research Council of South Africa.

The 7th French Airborne Forward Surgical Team experience of surgical support to the population of a low-income country: a prospective study on 341 patients with short-term follow-up

“…Recently a large study including 25 African countries reported that patients operated in Africa were twice as likely to die after surgery (2.1%) when compared with the global average for postoperative deaths 17. Operative mortality in resource-limited settings reported by ‘Médecins Sans Frontières’ ranged from 0.2% to 1.9%,13 16 but postoperative mortality was not detailed.…”

Improving the care for elective surgical patients: post-operative ICU admission and outcome

“…However, surgery implies in its nature an aggressive invasion of the boundaries (4) of the body which may be associated with life-threatening complications and impaired quality of life (5). Furthermore, according to previous reports, 5 billion people are unable to access safe and affordable surgical and anaesthetic care (6)(7)(8). Safe surgery has been considered a public health priority (9) and many efforts have been invested to outline the best strategy to be undertaken for the sake of surgical patients.…”

“…According to previous reports (7,8,13), national health systems and quality of health services are conditioned by the income of the country and the provision of available resources. Then, the organ reserve of the patient is one of the components impacting the outcome in the perioperative periods.…”

Perioperative evaluation of patients who are due to undergo surgery

“…[10] A recent publication in the Lancet reported on a 7day, international, prospective, observational cohort study of patients aged ≥18 years undergoing any inpatient surgery in 25 countries in Africa (African Surgical Outcomes Study). [11] A total of 11 422 patients were included from 247 hospitals serving a median population of 810 000, with a combined number of specialist surgeons, obstetricians and anaesthetists of 0.7/100 000 population. A median of 212 surgical procedures per 100 000 population were performed in hospitals each year.…”

“…The authors conclude that initiatives to increase access to surgical treatments in Africa therefore should be coupled with improved surveillance for deteriorating physiology in patients who develop postoperative complications and the resources necessary to achieve this objective. [11] In this CME issue, Du Toit et al [12] review the perioperative management of diabetes. In their comprehensive summary, the authors review the guidelines for optimisation and perioperative management of diabetic patients, and importantly place their discussion within the SA context.…”