Patients undergoing emergency surgery in lower-income countries have a 3 times greater chance of dying than in higher income countries, according to a new study.
The study, conducted by a team of leading researchers including scientists from the University of Sheffield in the UK, monitored post-surgery death rates and mapped them against the Human Development Index (HDI) of each country.
A total of 10,745 patients were monitored up to 30 days after they underwent emergency abdominal surgery, at hospitals in 58 participating countries. Published in British Journal of Surgery, the study showed that death rates were 3 times higher in low-income countries than in high-income countries, even after adjustment for prognostic factors such as fitness for surgery, diabetes history and smoking status.
The team behind the research, from the Universities of Sheffield, Birmingham and Edinburgh, believe that the study demonstrates a need to improve patient safety in low-income countries and revisit the use of the surgical safety checklists the standard global marker of hospital safety.
"This study is not only important due to the findings, it has demonstrated that hundreds of doctors and students can work as a team across the globe to deliver large studies which can make a real difference to our understanding of surgical patient care. We want to build upon this success as a community by delivering surgical trials which will improve the safety and outcomes for patients across the world," said Tom Drake from the University of Sheffield.
"We hope to take these findings and start to investigate the reasons behind these differences. Already we have a community of surgeons and researchers across the world to tackle these important priorities head on. Improving access and quality of surgical care will help to improve the lives of patients across the globe," Drake said.
It is believed that less than a third of the world population have access to safe, timely and affordable surgery. Only 6% of the 300 million surgical procedures performed each year take place in low or middle-income countries, despite a third of the world population living there.
"The association between increasing mortality and lower income countries might be explained by differences in prognosis, in treatment, or maybe both. What we can say is that our study highlights the significant disparity between countries, and an urgent need to address it," said Aneel Bhangu, from the University of Birmingham.
The team behind the research has developed a novel model of data collection, forming an international collaboration of doctors known as GlobalSurg. This network was created largely using social media, and data capture during the study was improved by use of a novel platform accessible from mobile Internet devices.
