Postoperative mortality in Africa: are there any improvements in the last decade?

Awuah, Wireko Andrew; Ng, Jyi Cheng; Nazir, Abubakar; Tenkorang, Pearl Ohenewaa; Yarlagadda, Rohan; Kalmanovich, Jacob; Abdul‐Rahman, Toufik; Akilimali, Aymar; Sikora, Vladyslav; Işık, Arda

doi:10.1097/js9.0000000000000125

Cited by 1 publication

(1 citation statement)

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“…An estimated 4·2 million people die worldwide within 30 days of surgery each year, and postoperative deaths account for ~8% of all deaths, making it the third leading cause of death after ischaemic heart disease and stroke 6 . In Africa, of 11 193 patients undergoing surgery in 25 African nations, 239 patients died and 225 died within 24 h following the operation; moreover, the risk of postoperative mortality in Africa doubled compared to the global average 7 .…”

Section: Introductionmentioning

confidence: 99%

Magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia: systematic review and meta-analysis

Tsehay,

Bogale,

Mulatu

et al. 2024

Annals of Medicine &Amp; Surgery

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Background: Postoperative mortality is one of the six surgical indicators identified by the Lancet Commission on Global Surgery for monitoring access to high-quality surgical care. This study aimed to assess the magnitude and associated factors of postoperative mortality among patients who underwent surgery in Ethiopia. Methods: This systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Ten studies were included in this Systematic review and meta-analysis. The risk of bias for each study was assessed using the Joanna Briggs Institute quality appraisal scale. Publication bias was checked using a funnel plot and Egger’s regression test. Heterogeneity across studies was assessed by I2 statistics. STATA version 17 software was used for analysis. A random effect model and the DerSimonian–Laird method of estimation was used to estimate the pooled magnitude of postoperative mortality. Odds ratios with 95% CIs were calculated to determine the associations of the identified factors with postoperative mortality. Results: The results revealed that the pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was 4.53% (95% CI :3.70–5.37). An American Society of Anesthesiologists score greater than or equal to III [adjusted odds ratio (AOR): 2.45, 95% CI: 2.02, 2.96], age older than or equal to 65 years (AOR: 3.03, 95% CI: 2.78, 3.31), and comorbidity (AOR: 3.28, 95% CI: 1.91, 5.63) were significantly associated with postoperative mortality. Conclusion and recommendations: The pooled magnitude of postoperative mortality among patients who underwent surgery in Ethiopia was high. The presence of comorbidities, age older than 65 years, and ASA physical status greater than III were significantly associated with postoperative mortality. Therefore, the Ministry of Health and other concerned bodies should consider quality improvement processes.

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Section: Introductionmentioning

confidence: 99%