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The South African Surgical Outcomes Study : a 7-day prospective observational cohort study

dc.contributor.authorBiccard, Bruce Marken_ZA
dc.contributor.authorMadiba, Thandinkosi E.en_ZA
dc.date.accessioned2016-08-10T14:06:05Z
dc.date.available2016-08-10T14:06:05Z
dc.date.issued2015
dc.identifier.citationBiccard, B. M. & Madiba, T. E. 2015. The South African Surgical Outcomes Study : a 7-day prospective observational cohort study. South African Medical Journal, 105(6):465-475, doi:10.7196/SAMJ.9435
dc.identifier.issn2078-5135 (online)
dc.identifier.issn0256-9574 (print)
dc.identifier.otherdoi:10.7196/SAMJ.9435
dc.identifier.urihttp://hdl.handle.net/10019.1/99355
dc.descriptionCITATION: Biccard, B. M. & Madiba, T. E. 2015. The South African Surgical Outcomes Study : a 7-day prospective observational cohort study. South African Medical Journal, 105(6):465-475, doi:10.7196/SAMJ.9435.
dc.descriptionThe original publication is available at http://www.samj.org.za
dc.description.abstractBackground. Non-cardiac surgical morbidity and mortality is a major global public health burden. Sub-Saharan African perioperative outcome data are scarce. South Africa (SA) faces a unique public health challenge, engulfed as it is by four simultaneous epidemics: (i) poverty-related diseases; (ii) non-communicable diseases; (iii) HIV and related diseases; and (iv) injury and violence. Understanding the effects of these epidemics on perioperative outcomes may provide an important perspective on the surgical health of the country. Objectives. To investigate the perioperative mortality and need for critical care admission in patients undergoing inpatient non-cardiac surgery in SA. Methods. A 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient noncardiac surgery between 19 and 26 May 2014 at 50 public sector, government-funded hospitals in SA. Results. The study included 3 927/4 021 eligible patients (97.7%) recruited, with 45/50 hospitals (90.0%) submitting data that described all eligible patients. Crude in-hospital mortality was 123/3 927 (3.1%; 95% confidence interval (CI) 2.6 - 3.7). The rate of postoperative admission to critical care units was 255/3 927 (6.5%; 95% CI 5.7 - 7.3), with 43.5% of admissions being unplanned. Of the surgical procedures 2 120/3 915 (54.2%) were urgent or emergency ones, with a population-attributable risk for mortality of 25.5% (95% CI 5.1 - 55.8) and a risk of admission to critical care of 23.7% (95% CI 4.7 - 51.4). Conclusions. Most patients in SA’s public sector hospitals undergo urgent and emergency surgery, which is strongly associated with mortality and unplanned critical care admissions. Non-communicable diseases have a larger proportional contribution to mortality than infections and injuries. However, the most common comorbidity, HIV infection, was not associated with in-hospital mortality. The study was registered on ClinicalTrials.gov (NCT02141867).en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaaraf_ZA
dc.description.urihttp://www.samj.org.za/index.php/samj/article/view/10027
dc.format.extent11 pagesen_ZA
dc.language.isoen_ZAen_ZA
dc.publisherHealth and Medical Publishing Groupen_ZA
dc.subjectNon-cardiac surgeryen_ZA
dc.subjectHuman beings -- Diseasesen_ZA
dc.subjectMorbidityen_ZA
dc.subjectMortalityen_ZA
dc.titleThe South African Surgical Outcomes Study : a 7-day prospective observational cohort studyen_ZA
dc.typeArticleen_ZA
dc.description.versionPublisher's version
dc.rights.holderHealth & Medical Publishing Groupen_ZA


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