Surgery in Developing Countries Has Low Mortality

Study finds 0.2 percent operative mortality in programs in 13 countries
By Jeff Muise
HealthDay Reporter

WEDNESDAY, Aug. 18 (HealthDay News) -- Operative mortality is generally low in surgical programs in resource-limited countries, according to a study in the August issue of the Archives of Surgery.

Kathryn M. Chu, M.D., of the Johns Hopkins Medical Institutions in Baltimore, and colleagues reported on 17 surgical programs in 13 developing countries run by Médecins Sans Frontières during 2001 to 2008. The study looked at operative mortality, and used logistic regression to identify mortality determinants.

The researchers found that, during the study period, operative mortality was low at 0.2 percent, with eight of the surgical programs reporting no deaths and the highest mortality rate at 0.9 percent. Of 19,643 surgical procedures performed, 42 percent were emergent, 40 percent were obstetric related, and 14 percent were trauma related. Operative mortality was associated with American Society of Anesthesiologists classifications of 3 to 5 (adjusted odds ratio [aOR], 20.2), procedures performed under emergency conditions (aOR, 20.1), hysterectomy (aOR, 12.3), surgical programs in locations with ongoing conflicts (aOR, 4.6), and abdominal surgical procedures (aOR, 3.4).

"Surgical care can be provided safely in resource-limited settings with appropriate minimum standards and protocols. Studies on the burden of surgical disease in these populations are needed to improve service planning and delivery. Quality improvement programs are needed for the various stakeholders involved in surgical delivery in these settings," the authors write.

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