Ways to improve surgical outcomes in low- and middle-income countries

Barth, Cornelia Anne; Wladis, Andreas; Roy, Nobhojit; Blake, Catherine; Kolo, Sanda Muhammad; O’Sullivan, Cliona

doi:10.2471/blt.22.287950

Cited by 5 publications

(4 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though it has been developed, used and tested within MSF projects, the AIM-T is intended to be useful in any health facilities providing trauma care, and especially where resources are limited. However, health authorities’ awareness on the importance of collecting such data within trauma care is required, consistent with the more global call for stronger health information systems in LMICs [ 19 , 109 , 110 ]. Additionally, to ensure quality of data, a training package has been compiled for healthcare professionals, enhancing the AIM-T reliability and implementation.…”

Section: Discussionmentioning

confidence: 99%

“…Their measurement is therefore an essential part of daily clinical practice, while also being useful for trauma care monitoring. In particular, the use of measures of independence in activities based on observation may increase opportunities to perform such activities within routine care, thereby encouraging early mobilization, which is a common challenge in humanitarian settings [ 19 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, indicators used for trauma care monitoring have mainly focused on hospital processes and morbidity and mortality outcomes rather than on disability [5,[12][13][14][15]. However, functioning has increasingly been recommended as a quality indicator of trauma care [14,[16][17][18][19]. Full functioning and complete disability are extremes of the same continuum, capturing the "dynamic interaction between a person's health condition, environmental factors and personal factors" [20,21].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessing independence in mobility activities in trauma care: Validity and reliability of the Activity Independence Measure-Trauma (AIM-T) in humanitarian settings

Gohy,

Opava,

von Schreeb

et al. 2023

PLOS Glob Public Health

View full text Add to dashboard Cite

The importance of measuring outcomes after injury beyond mortality and morbidity is increasingly recognized, though underreported in humanitarian settings. To address shortcomings of existing outcome measures in humanitarian settings, the Activity Independence Measure-Trauma (AIM-T) was developed, and is structured in three subscales (i.e., core, lower limb, and upper limb). This study aimed to assess the AIM-T construct validity (structural validity and hypothesis testing) and reliability (internal consistency, inter-rater reliability and measurement error) in four humanitarian settings (Burundi, Iraq, Cameroon and Central African Republic). Patients with acute injury (n = 195) were assessed using the AIM-T, the Barthel Index (BI), and two pain scores. Structural validity was assessed through confirmatory factor analysis. Hypotheses were tested regarding correlations with BI and pain scores using Pearson correlation coefficient (PCC) and differences in AIM-T scores between patients’ subgroups, using standardized effect size Cohen’s d (d). Internal consistency was assessed with Cronbach’s alpha (α). AIM-T was reassessed by a second rater in 77 participants to test inter-rater reliability using intraclass correlation coefficient (ICC). The results showed that the AIM-T structure in three subscales had an acceptable fit. The AIM-T showed an inverse weak to moderate correlation with both pain scores (PCC<0.7, p≤0.05), positive strong correlation with BI (PCC≥0.7, p≤0.05), and differed between all subgroups (d≥0.5, p≤0.05). The inter-rater reliability in the (sub)scales was good to excellent (ICC 0.86–0.91) and the three subscales’ internal consistency was adequate (α≥0.7). In conclusion, this study supports the AIM-T validity in measuring independence in mobility activities and its reliability in humanitarian settings, as well as it informs on its interpretability. Thus, the AIM-T could be a valuable measure to assess outcomes after injury in humanitarian settings.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessing independence in mobility activities in trauma care: Validity and reliability of the Activity Independence Measure-Trauma (AIM-T) in humanitarian settings

Gohy,

Opava,

von Schreeb

et al. 2023

PLOS Glob Public Health

View full text Add to dashboard Cite

show abstract

“…It has been well established that rehabilitation following surgery can reduce complications and improves postoperative and functional outcomes. However, surgery-related rehabilitation is rarely actually recognized as an essential part of the continuum of care ( 37 ). Beyond post-operative rehabilitation, another emerging idea is pre-habilitation prior to surgery.…”

Section: Discussionmentioning

confidence: 99%

Social vulnerability is associated with post-operative morbidity following robotic-assisted lung resection

Stuart,

Dyas,

Byers

et al. 2023

J Thorac Dis

View full text Add to dashboard Cite

Background The social vulnerability index (SVI) is a neighborhood-based metric used to determine an individual’s susceptibility to socioeconomic hardship, with high SVI indicating high susceptibility. SVI has previously been associated with surgical outcomes. We aimed to determine if SVI influences morbidity following robotic-assisted lung resection. Methods This was a retrospective cohort study at one academic medical center (1/1/2021–11/30/2022). Patients undergoing robotic-assisted lung resection were grouped into low (<75 th percentile) and high (≥75 th percentile) SVI cohorts. The primary outcome was 30-day overall morbidity; secondary outcomes were individual 30-day post-operative outcomes. Univariate analysis was performed using Chi-squared or Mann-Whitney- U tests, and multivariable logistic regression was performed to generate risk-adjusted odds ratios (ORs) of postoperative complications. Results We included 320 patients, of which 40 patients (12.5%) in the high-SVI group and 280 (87.5%) in the low-SVI group. High SVI patients were more likely to be non-Caucasian and of Hispanic ethnicity, but there were no other differences in perioperative characteristics (all P>0.05). High SVI patients were more likely to experience a post-operative complication (42.5% vs. 24.6%, P=0.017), surgical site infection (SSI) (12.5% vs. 4.3%, P=0.047), hemothorax (5.0% vs. 0.0%, P=0.015), intensive care need (15.0% vs. 4.6%, P=0.021), sepsis (10.0% vs. 1.1%, P=0.006) and unplanned reoperation (5.0% vs. 0.4%, P=0.042). After risk-adjustment, the association of increased overall morbidity with high SVI persisted (OR =2.53; 95% confidence interval: 1.19–5.35). Conclusions High SVI was associated with increased risk-adjusted odds of morbidity after robotic-assisted lung resection. Highly vulnerable patients should be allocated perioperative resources to help mitigate the increased risk of these complications.

show abstract

The state of African surgical research capacity: highlighting the current efforts, challenges, and recommendations – Editorial

Awuah

Tenkorang

Adebusoye

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

Ways to improve surgical outcomes in low- and middle-income countries

Cited by 5 publications

References 42 publications

Assessing independence in mobility activities in trauma care: Validity and reliability of the Activity Independence Measure-Trauma (AIM-T) in humanitarian settings

Assessing independence in mobility activities in trauma care: Validity and reliability of the Activity Independence Measure-Trauma (AIM-T) in humanitarian settings

Social vulnerability is associated with post-operative morbidity following robotic-assisted lung resection

The state of African surgical research capacity: highlighting the current efforts, challenges, and recommendations – Editorial

Contact Info

Product

Resources

About