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IRIS
Background: Gastrointestinal perforation is the most serious complication of typhoid fever, with a high disease burden in low-income countries. Reliable, prospective, contemporary surgical outcome data are scarce in these settings. This study aimed to investigate surgical outcomes following surgery for intestinal typhoid. Methods: Two multicentre, international prospective cohort studies of consecutive patients undergoing surgery for gastrointestinal typhoid perforation were conducted. Outcomes were measured at 30 days and included mortality, surgical site infection, organ space infection and reintervention rate. Multilevel logistic regression models were used to adjust for clinically plausible explanatory variables. Effect estimates are expressed as odds ratios (ORs) alongside their corresponding 95% confidence intervals. Results: A total of 88 patients across the GlobalSurg 1 and GlobalSurg 2 studies were included, from 11 countries. Children comprised 38.6% (34/88) of included patients. Most patients (87/88) had intestinal perforation. The 30-day mortality rate was 9.1% (8/88), which was higher in children (14.7 vs. 5.6%). Surgical site infection was common, at 67.0% (59/88). Organ site infection was common, with 10.2% of patients affected. An ASA grade of III and above was a strong predictor of 30-day post-operative mortality, at the univariable level and following adjustment for explanatory variables (OR 15.82, 95% CI 1.53–163.57, p = 0.021). Conclusions: With high mortality and complication rates, outcomes from surgery for intestinal typhoid remain poor. Future studies in this area should focus on sustainable interventions which can reduce perioperative morbidity. At a policy level, improving these outcomes will require both surgical and public health system advances.
Management and Outcomes Following Surgery for Gastrointestinal Typhoid: An International, Prospective, Multicentre Cohort Study
Anyomih T. T. K.;Drake T. M.;Glasbey J.;Fitzgerald J. E.;Ots R.;Harrison E. M.;Tabiri S.;Bhangu A.;Ademuyiwa A. O.;Aguilera M. L.;Alexander P.;Al-Saqqa S. W.;Borda-Luque G.;Costas-Chavarri A.;Ntirenganya F.;Fergusson S. J.;Allen Ingabire J. C.;Ismail L.;Salem H. K.;Kojo A. T. T.;Lapitan M. C.;Lilford R.;Mihaljevic A. L.;Morton D.;Mutabazi A. Z.;Nepogodiev D.;Adisa A. O.;Pata F.;Pinkney T.;Poskus T.;Qureshi A. U.;la Medina A. R. -D.;Rayne S.;Shaw C. A.;Shu S.;Spence R.;Smart N.;Manipal C. E.;Mohan M.;Jeyakumar J.;Mitul A. R.;Mahmud K.;Hussain M.;Hakim H.;Kumar T.;Oosterkamp A.;Abantanga F.;Boakye-Yiadom K.;Bukari M.;Owusu F.;Awuku-Asabre J.;Bray L. D.;Prasad S. S.;Kirishnan A.;Gyanchandani N.;Kumar B. S.;Rangarajan M.;Bhat S.;Sreedharan A.;Kinnera S. V.;Reddy Y.;Venugopal C.;Kumar S.;Mittal A.;Nadkarni S.;Lakshmi H. N.;Malik P.;Limaye N.;Pai S.;Jain P.;Khajanchi M.;Satoskar S.;Satoskar R.;Mahamood A. B.;Coomber R.;Johnson K.;Nowers J.;Mohammad A.;Anyanwu L. -J.;Sheshe A.;Adesina A.;Faturoti O.;Taiwo O.;Ibrahim M. H.;Nasir A. A.;Suleiman S. I.;Adeniyi A.;Adesanya O.;Adebanjo A.;Williams O.;Atobatele K.;Ogunyemi A.;Oludara M.;Oshodi O.;Osuoji R.;Lawal A. R. O.;Alakaloko F.;Elebute O.;Osinowo A.;Bode C.;Adesuyi A.;Tade A.;Adekoya A.;Nwokoro C.;Ayandipo O. O.;Lawal T. A.;Ajao A. E.;Ali S. S.;Odeyemi B.;Olori S.;Popoola A.;Adeyeye A.;Adeniran J.;Bhopal K. F.;Iftikhar Z.;Furqan M. M.;Nighat B.;Jawaid M.;Khalique A.;Zil-E-Ali A.;Rashid A.;Dharamshi H. A.;Naqvi T.;Faraz A.;Anwar A. W.;Yaseen T. M.;Shamsi G. S.;Anwer W.;Arachchi P. P.;Senanayake W. S. M. K. J.;Arachchige L. A. J. J.;Sivaganesh S.;Samaraweera D. I.;Thanusan V.;Tew Y. Y.;Gala T.;Djivoh F.;Dossou F.;Seto D. M.;Gbessi D. G.;Noukpozounkou B.;Souaibou Y. I.;Keke K. R.;Hodonou F.;Ahounou E. Y. S.;Alihonou T.;Denakpo M.;Ahlonsou G.;Bandoh D.;Kyereh M.;Asumah H.;Appiah E. K.;Wondoh P.;Gyedu A.;Dally C.;Agbedinu K.;Amoah M.;Yifieyeh A.;Amoako-Boateng M.;Dayie M.;Hagan R.;Debrah S.;Ohene-Yeboah M.;Clegg-Lampety J. -N.;Etwire V.;Dakubo J.;Essoun S.;Bonney W.;Glover-Addy H.;Osei-Nketiah S.;Amoako J.;Adu-Aryee N.;Appeadu-Mensah W.;Bediako-Bowan A.;Dedey F.;Ekow M.;Akatibo E.;Yakubu M.;Kordorwu H. E. K.;Asare-Bediako K.;Tackie E.;Aaniana K.;Acquah E.;Opoku-Agyeman R.;Avoka A.;Kusi K.;Maison K.;Gyamfi F. E.;Barnabas G. N.;Abdul-Latif S.;Amoako P. T.;Davor A.;Dassah V.;Dagoe E.;Kwakyeafriyie P.;Akoto E.;Ackom E.;Mensah E.;Atkins E. T.;Coompson C. L.;Yusufali T.;Mohammed H.;Lando J.;Parker R.;Ndegwa W.;Chai F. Y.;Asilah S. M. D.;Syibrah K. Z.;Chin P. X.;Salleh A.;Riswan N. Z.;Roslani A. C.;Chong H. -Y.;Aziz N. A.;Poh K. -S.;Chai C. -A.;Kumar S.;Taher M. M.;Kosai N. R.;Aziz D. N. A.;Rajan R.;Julaihi R.;Jethwani D. L.;Yahaya M. T.;Abdullah N. A. N.;Mathew S. W.;Chung K. J.;Nirumal M. K.;Goh Ern Tze R.;Ali S. A. W. E. W.;Gan Y. Y.;Ting J. R. S.;Sii S. S. Y.;Koay K. L.;Tan Y. K.;Cheah A. E. Z.;Wong C. Y.;Mat T. N. A. T.;Chow C. Y. N.;Har P. A. L.;Der Y.;Henry F.;Low X.;Neo Y. T.;Heng H. E.;Kong S. N.;Gan C.;Mok Y. T.;Tan Y. W.;Palayan K.;Tata M. D.;Cheong Y. J.;Gunaseelan K.;Nasir W. N. A. W. M.;Yoganathan P.;Lee E. X.;Saw J. E.;Yeang L. J.;Koh P. Y.;Lim S. Y.;Teo S. Y.;Abdurrazzaaq A.;Alada M.;Habeeb O.;Mendel H.;Bello B.;Muktar U.;Olajide T. O.;Oshati O.;Ihediwa G.;Adenekan B.;Nwinee V.;Bode C.;Olugbemi M.;Odutola O.;Adebola O.;Onuoha C.;Balogun F.;Ajai O.;Njokanma I.;Kache S.;Ajah J.;Makama J.;Adamu A.;Baba S.;Aliyu M.;Aliyu S.;Ukwenya Y.;Aliyu H.;Sholadoye T.;Daniyan M.;Ogunsua O.;Mshelbwala P.;Samson G.;Timothy O. K.;Samuel S. A.;Ajiboye A.;Amole I.;Abiola O.;Olaolorun A.;Nadeem N.;Saqlain M.;Abbasy J.;Alvi A. R.;Shahzad N.;Butt M. T.;Razi S. A.;Ahmed A.;Niazi A. K.;Raza I.;Baluch F.;Raza A.;Bani-Sadar A.;Adil M.;Raza A.;Javaid M.;Waqar M.;Khan M. A.;Arshad M. M.;Amjad M.;Uzabumwana N.;Duhoranenayo D.;Clegg-Lamptey J. -N.;Imoro O.;Abem O. E.;Sale D.;Abdullahi L.;Osagie O.;Faboya O.;Fatuga A.;Taiwo A.;Nwabuoku E.;Khan Z. A.;Rickard J.;Tan C. L.;Siaw J. Y.;Yam S. Y.;Wilson L.;Aziz M. R. A.
2018-01-01
Abstract
Background: Gastrointestinal perforation is the most serious complication of typhoid fever, with a high disease burden in low-income countries. Reliable, prospective, contemporary surgical outcome data are scarce in these settings. This study aimed to investigate surgical outcomes following surgery for intestinal typhoid. Methods: Two multicentre, international prospective cohort studies of consecutive patients undergoing surgery for gastrointestinal typhoid perforation were conducted. Outcomes were measured at 30 days and included mortality, surgical site infection, organ space infection and reintervention rate. Multilevel logistic regression models were used to adjust for clinically plausible explanatory variables. Effect estimates are expressed as odds ratios (ORs) alongside their corresponding 95% confidence intervals. Results: A total of 88 patients across the GlobalSurg 1 and GlobalSurg 2 studies were included, from 11 countries. Children comprised 38.6% (34/88) of included patients. Most patients (87/88) had intestinal perforation. The 30-day mortality rate was 9.1% (8/88), which was higher in children (14.7 vs. 5.6%). Surgical site infection was common, at 67.0% (59/88). Organ site infection was common, with 10.2% of patients affected. An ASA grade of III and above was a strong predictor of 30-day post-operative mortality, at the univariable level and following adjustment for explanatory variables (OR 15.82, 95% CI 1.53–163.57, p = 0.021). Conclusions: With high mortality and complication rates, outcomes from surgery for intestinal typhoid remain poor. Future studies in this area should focus on sustainable interventions which can reduce perioperative morbidity. At a policy level, improving these outcomes will require both surgical and public health system advances.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11770/345585
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simulazione ASN
Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande.
La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.
