Perioperative mortality among geriatric patients in Ethiopia: a prospective cohort study.
Ethiopia
geriatrics
outcome
postoperative mortality
surgery
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2023
2023
Historique:
received:
17
05
2023
accepted:
09
10
2023
medline:
29
11
2023
pubmed:
29
11
2023
entrez:
29
11
2023
Statut:
epublish
Résumé
With the dramatic growth in the aged population observed in developed and developing nations, the older population burdened by unmet demand for surgical treatment has become a significant yet unnoticed public health concern in resource-limited countries. Studies are limited regarding surgical mortality of geriatric patients in Africa. Therefore, this study aims to estimate the incidence and identify predictors of postoperative mortality using prospective data in a low-income country, Ethiopia. A prospective cohort study was conducted from June 01, 2019, to June 30, 2021, at a tertiary-level hospital in Ethiopia. Perioperative data were collected using an electronic data collection tool. Cox regression analysis was used to identify predictor variables. The association between predictors and postoperative mortality among geriatrics was computed using a hazard ratio (HR) with a 95% confidence interval (CI); Of eligible 618 patients, 601 were included in the final analysis. The overall incidence of postoperative mortality among geriatrics was 5.16%, with a rate of 1.91 (95% CI: 1.34, 2.72) deaths per 1,000 person-day observation. Age ≥ 80 years (Adjusted hazard ratio (AHR) = 2.59, 95% CI: 1.05, 6.36), ASA physical status III/IV (AHR = 2.40, 95%CI 1.06, 5.43), comorbidity (AHR = 2.53, 95% CI: 1.19, 7.01), and emergency surgery (AHR = 2.92, 95% CI: 1.17, 7.27) were the significant predictors of postoperative mortality among older patients. Postoperative mortality among geriatrics was high. Identified predictors were age ≥ 80 years, ASA status III/IV, comorbidity, and emergency surgery. Target-specific interventions should be addressed to improve high surgical mortality in these patients.
Sections du résumé
Background
UNASSIGNED
With the dramatic growth in the aged population observed in developed and developing nations, the older population burdened by unmet demand for surgical treatment has become a significant yet unnoticed public health concern in resource-limited countries. Studies are limited regarding surgical mortality of geriatric patients in Africa. Therefore, this study aims to estimate the incidence and identify predictors of postoperative mortality using prospective data in a low-income country, Ethiopia.
Methods and materials
UNASSIGNED
A prospective cohort study was conducted from June 01, 2019, to June 30, 2021, at a tertiary-level hospital in Ethiopia. Perioperative data were collected using an electronic data collection tool. Cox regression analysis was used to identify predictor variables. The association between predictors and postoperative mortality among geriatrics was computed using a hazard ratio (HR) with a 95% confidence interval (CI);
Results
UNASSIGNED
Of eligible 618 patients, 601 were included in the final analysis. The overall incidence of postoperative mortality among geriatrics was 5.16%, with a rate of 1.91 (95% CI: 1.34, 2.72) deaths per 1,000 person-day observation. Age ≥ 80 years (Adjusted hazard ratio (AHR) = 2.59, 95% CI: 1.05, 6.36), ASA physical status III/IV (AHR = 2.40, 95%CI 1.06, 5.43), comorbidity (AHR = 2.53, 95% CI: 1.19, 7.01), and emergency surgery (AHR = 2.92, 95% CI: 1.17, 7.27) were the significant predictors of postoperative mortality among older patients.
Conclusion
UNASSIGNED
Postoperative mortality among geriatrics was high. Identified predictors were age ≥ 80 years, ASA status III/IV, comorbidity, and emergency surgery. Target-specific interventions should be addressed to improve high surgical mortality in these patients.
Identifiants
pubmed: 38020168
doi: 10.3389/fmed.2023.1220024
pmc: PMC10651902
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1220024Informations de copyright
Copyright © 2023 Endeshaw, Molla and Kumie.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
PLoS One. 2014 Jan 15;9(1):e83795
pubmed: 24454708
Med Intensiva (Engl Ed). 2018 Nov;42(8):463-472
pubmed: 29502889
Anesthesiology. 2015 Dec;123(6):1312-21
pubmed: 26492481
ANZ J Surg. 2022 Sep;92(9):2018-2024
pubmed: 35373437
Ter Arkh. 2016;88(1):4-10
pubmed: 26978602
Anaesthesia. 2014 Jan;69 Suppl 1:8-16
pubmed: 24303856
BMC Geriatr. 2020 Nov 26;20(1):507
pubmed: 33243161
BMC Surg. 2020 Jan 13;20(1):11
pubmed: 31931774
Anesthesiology. 2017 Aug;127(2):250-271
pubmed: 28657959
Asian J Urol. 2017 Jan;4(1):44-49
pubmed: 29264206
Medicine (Baltimore). 2016 Jan;95(2):e2208
pubmed: 26765400
J Am Coll Surg. 2006 Dec;203(6):865-77
pubmed: 17116555
Can J Surg. 2015 Oct;58(5):312-7
pubmed: 26204143
Minerva Anestesiol. 2011 Jun;77(6):637-46
pubmed: 21617627
Anaesthesia. 2014 Jan;69 Suppl 1:81-98
pubmed: 24303864
J Clin Med. 2022 Sep 08;11(18):
pubmed: 36142942
JAMA Netw Open. 2020 Aug 3;3(8):e209265
pubmed: 32822490
Eur Respir J. 2014 Oct;44(4):1055-68
pubmed: 25142482
Asian J Anesthesiol. 2021 Jun 15;59(2):58-68
pubmed: 34139808
Ann Surg. 1994 Jul;220(1):3-9
pubmed: 8024356
J Surg Res. 2021 Mar;259:192-199
pubmed: 33302219
BMC Geriatr. 2017 Oct 24;17(1):245
pubmed: 29065869
Ethn Dis. 2009 Summer;19(3):359-62
pubmed: 19769021
Ann Surg. 2003 Aug;238(2):170-7
pubmed: 12894008
BMJ Glob Health. 2018 Jun 22;3(3):e000810
pubmed: 29989045
Br J Surg. 2016 Jan;103(2):e7-9
pubmed: 26771471
J Clin Anesth. 2018 Sep;49:79-86
pubmed: 29909205
BMC Med. 2018 Jan 12;16(1):2
pubmed: 29325567
Acta Anaesthesiol Scand. 2006 Jan;50(1):19-25
pubmed: 16451146
PLoS One. 2020 Jun 5;15(6):e0233857
pubmed: 32502177
Am J Manag Care. 2012 Nov 01;18(11):e405-15
pubmed: 23198750
Int J Surg. 2013;11(9):872-5
pubmed: 23917211
Afr Health Sci. 2019 Mar;19(1):1778-1788
pubmed: 31149008
World J Surg. 2015 Mar;39(3):652-7
pubmed: 25446472