Key result
General anesthesia linked to ~4% 24-hour mortality, driven by age, emergencies, and higher ASA status.
Why the study?
General anaesthesia in developing countries carries high morbidity and mortality, but no study had yet determined mortality related to general anaesthesia practice in Butembo, Democratic Republic of the Congo.
Observational (n=921)
Yes
General anaesthesia in this limited-resource setting carries a very high mortality rate (4.1% within 24 hours), highlighting the urgent need for trained providers, better monitoring, and improved infrastructure.
High GA mortality in this resource-limited cohort warrants heightened vigilance; leaves open whether targeted interventions reduce deaths in similar settings.
BACKGROUND: General anaesthesia (GA) in developing countries is still a high-risk practice, especially in Africa, accompanied with high morbidity and mortality. No study has yet been conducted in Butembo in the Democratic Republic of the Congo to determine the mortality related to GA practice. The main objective of this study was to assess mortality related to GA in Butembo. METHODS: This was a retrospective descriptive and analytic study of patients who underwent surgery under GA in the 2 main teaching hospitals of Butembo from January 2011 to December 2015. Data were collected from patients files, anaesthesia registries and were analysed with SPSS 26. RESULTS: From a total of 921 patients, 539 (58.5%) were male and 382 (41.5%) female patients. A total of 83 (9.0%) patients died representing an overall perioperative mortality rate of 90 per 1000. Out of the 83 deaths, 38 occurred within 24 h representing GA related mortality of 41 per 1000. There was a global drop in mortality from 2011 to 2015. The risk factors of death were: being a neonate or a senior adult, emergency operation, ASA physical status > 2 and a single deranged vital sign preoperatively, presenting any complication during GA, anaesthesia duration > 120 minutes as well as visceral surgeries/laparotomies. Ketamine was the most employed anaesthetic. CONCLUSION: GA related mortality is very high in Butembo. Improved GA services and outcomes can be obtained by training more anaesthesia providers, proper patients monitoring, improved infrastructure, better equipment and drugs procurement and considering regional anaesthesia whenever possible.
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Pascal et al. (2021) conducted an observational in Patients undergoing surgery under general anaesthesia (n=921). General anaesthesia was evaluated on General anaesthesia related mortality (within 24 hours). General anaesthesia-related mortality within 24 hours was 4.1% among patients undergoing surgery in Butembo, with extreme age, emergency procedures, and higher ASA physical status as key risk factors.
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