Perioperative mortality in low-, middle-, and high-income countries: Protocol for a multi-level meta-regression analysis.

Humans Perioperative Period Systematic Reviews as Topic Regression Analysis Developing Countries Developed Countries / statistics & numerical data Meta-Analysis as Topic

Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2024
Historique:
received: 05 07 2023
accepted: 15 04 2024
medline: 2 11 2024
pubmed: 2 11 2024
entrez: 1 11 2024
Statut: epublish

Résumé

Surgery is an indispensable component of a functional healthcare system. To date there is limited information regarding how many people die during the perioperative period globally. This study describes a protocol for a systematic review and multilevel meta-regression to evaluate time trends regarding the odds of perioperative mortality among adults undergoing a bellwether surgical procedure while accounting for higher order clustering at the national level. Published studies reporting the number of perioperative deaths from bellwether surgical procedures among adults will be identified from MEDLINE, Embase, Cochrane CENTRAL, LILACS and Global Index Medicus. The primary outcome will be the rate of perioperative mortality across time and the secondary outcome will be investigating cause of death over time as a proportion of overall perioperative mortality. Two reviewers will independently conduct full text screening and extract the data. Disagreements will first be resolved via consensus. If consensus cannot be reached a third reviewer will be included to arbitrate. Due to human resource limitations, a risk of bias appraisal will not be conducted. From the included studies a multilevel meta-regression will be constructed to synthesize the results. This model will conceptualize patients as nested in studies which are in turn nested within countries while taking into account potential confounding variables at all levels. The systematic review and multilevel meta-regression that will be conducted based on this protocol will provide synthesized global evidence regarding the trends of perioperative mortality. This eventual study may help policymakers and other key stakeholders with benchmarking surgical safety initiatives as well as identify key gaps in our current understanding of global perioperative mortality. Systematic review registration: PROSPERO registration number 429040.

Sections du résumé

BACKGROUND BACKGROUND
Surgery is an indispensable component of a functional healthcare system. To date there is limited information regarding how many people die during the perioperative period globally. This study describes a protocol for a systematic review and multilevel meta-regression to evaluate time trends regarding the odds of perioperative mortality among adults undergoing a bellwether surgical procedure while accounting for higher order clustering at the national level.
METHODS METHODS
Published studies reporting the number of perioperative deaths from bellwether surgical procedures among adults will be identified from MEDLINE, Embase, Cochrane CENTRAL, LILACS and Global Index Medicus. The primary outcome will be the rate of perioperative mortality across time and the secondary outcome will be investigating cause of death over time as a proportion of overall perioperative mortality. Two reviewers will independently conduct full text screening and extract the data. Disagreements will first be resolved via consensus. If consensus cannot be reached a third reviewer will be included to arbitrate. Due to human resource limitations, a risk of bias appraisal will not be conducted. From the included studies a multilevel meta-regression will be constructed to synthesize the results. This model will conceptualize patients as nested in studies which are in turn nested within countries while taking into account potential confounding variables at all levels.
DISCUSSION CONCLUSIONS
The systematic review and multilevel meta-regression that will be conducted based on this protocol will provide synthesized global evidence regarding the trends of perioperative mortality. This eventual study may help policymakers and other key stakeholders with benchmarking surgical safety initiatives as well as identify key gaps in our current understanding of global perioperative mortality.
TRIAL REGISTRATION BACKGROUND
Systematic review registration: PROSPERO registration number 429040.

Identifiants

DOI: 10.1371/journal.pone.0288888 PMID: 39485783
pubmed: 39485783
doi: 10.1371/journal.pone.0288888
pii: PONE-D-23-20961
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0288888

Informations de copyright

Copyright: © 2024 McIntyre et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Auteurs

Kevin J McIntyre (KJ)

Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.
ORCID: 0000-0002-2900-3016

Yun-Hee Choi (YH)

Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.

Ava John-Baptiste (A)

Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.
Interfaculty Program in Public Health, Western University, London, Ontario, Canada.

Daniel J Lizotte (DJ)

Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Interfaculty Program in Public Health, Western University, London, Ontario, Canada.

Eunice Y S Chan (EYS)

Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.
School of Medicine, The Chinese University of Hong Kong, Shenzhen, Guangdong, P. R. China.

Jessica Moodie (J)

Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.

Saverio Stranges (S)

Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Department of Medicine, Western University, London, Ontario, Canada.
Department of Family Medicine, Western University, London, Ontario, Canada.
Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.

Janet Martin (J)

Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada.
Department of Anesthesia & Perioperative Medicine, Centre for Medical Evidence Decision Integrity Clinical Impact (MEDICI), Western University, London, Ontario, Canada.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Perioperative mortality in low-, middle-, and...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Période périopératoire › Perioperative mortality in low-, middle-, and...
questionsmedicales.fr › Sciences de l'information › Sources d'information › Moyens de communication › Publications › Littérature de revue comme sujet › Revues systématiques comme sujet › Perioperative mortality in low-, middle-, and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de régression › Perioperative mortality in low-, middle-, and...
questionsmedicales.fr › Sciences sociales › Internationalité › Coopération internationale › Pays en voie de développement › Perioperative mortality in low-, middle-, and...
questionsmedicales.fr › Sciences sociales › Internationalité › Coopération internationale › Pays développés › Perioperative mortality in low-, middle-, and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Méta-analyse comme sujet › Perioperative mortality in low-, middle-, and...