Key result
Compared to cesarean section, 24-hour perioperative mortality was significantly higher for urology and general surgery (OR 8.03; 95% CI 3.98-47.33; P=0.0002), neurosurgery, and trauma.
Why the study?
Perioperative mortality rate indicates anesthesia and surgical safety, but documentation is poor in low- and middle-income countries.
Are specific surgical procedures associated with higher perioperative mortality at 24 h and 48 h compared to cesarean section delivery in an Ethiopian teaching hospital?
Cohort (n=885)
No
Are specific surgical procedures associated with higher perioperative mortality at 24 h and 48 h compared to cesarean section delivery in an Ethiopian teaching hospital?
Odds Ratio: 8.03 (95% CI 3.98–47.33)
p-value: p=0.0002
In a prospective Ethiopian cohort, urology, general surgery, neurosurgery, orthopedics, emergency surgery, and trauma were associated with significantly higher 24-hour and 48-hour perioperative mortality compared to cesarean section.
Should not yet change practice; leaves open generalizability beyond this single-center Ethiopian cohort.
Background: Perioperative mortality rate is the basic indicator of anesthesia and surgery safety in a country of health policy. However, documentation is poor in low and middle income countries. So we developed a simple prospective data collection tool for perioperative mortality determination at Tibebe Ghion Specialized Teaching Hospital, Ethiopia. Material and methods: The prospective electronic based data collection was done at Tibebe Ghion Specialized Teaching Hospital, Ethiopia with case specific of perioperative data. We compared patients with mortality at 24 h, and 48 h by Kaplan-Meier (KM) survival analysis. Logistic regression model was used to evaluate the effect of different surgical procedures on mortality. Results: From August 2019, to December 2019 data were taken from 946 cases at Tibebe Ghion Specialized Teaching Hospital. We excluded 61 (6.44%) cases with missing data information. The logistic regression analysis for 24 h mortality showed that urology and general surgery (OR = 8.03 [95% CI, 3.98 to 47.33]; P = 0.0002),neurosurgery (OR = 4.77, [95% CI,2.58–17.70]; P = 0.01), orthopedics (OR = 1.21, [95% CI,0.56–6.89]; P = 0.003), emergency surgery (OR = 2.76 [95% CI,1.03–10.51]; P = 0.04) and trauma (OR = 6.94 [95% CI,3.43–26.32]; P = 0.002) were associated with high risk of mortality (Table 3) as compared to cesarean section delivery. These significant relations were also revealed at 48 h of mortality. Other Surgeries and pediatrics category were not correlated to 24 h and 48 h of mortality. Conclusion and recommendation: There were a significant higher magnitude of mortality recorded over Urology and general surgeries, neurosurgery, orthopedic surgery, emergency surgery and trauma compared with cesarean section delivery at Tibebe Ghion Specialized Teaching Hospital. In addition, we observed the mortality rate differences between each surgical category. Tibebe Ghion Specialized Teaching Hospital should emphasis on monitoring and evaluation of patients’ outcome for the reduction of mortality. We also recommended doing this research work at multiple centers of referral hospitals for better valid information. Highlights:
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Asfaw et al. (2020) conducted a cohort in Perioperative mortality (n=885). Urology and general surgery vs. Cesarean section delivery was evaluated on 24-hour mortality (OR 8.03, 95% CI 3.98-47.33, p=0.0002). Compared to cesarean section, 24-hour perioperative mortality was significantly higher for urology and general surgery (OR 8.03; 95% CI 3.98-47.33; P=0.0002), neurosurgery, and trauma.
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