Perioperative Mortality Rate (pomr) in a Low-resource Non-governmental Organization (ngo) Hospital Setting in India.

Abstract OBJECTIVES Globally congenital heart disease mortality is declining, yet the proportion of infant deaths attributable to heart disease rises in Colombia and other middle-sociodemographic countries. We aimed to assess the accessibility of paediatric cardiac surgery (PCS) to children <18 years of age in 2016 in the South American country of Colombia. METHODS In Bogotá, Colombia, a multi-national team used cross-sectional and retrospective cohort study designs to adapt and evaluate 4 health system indicators at the national level: first, the population with timely geographic access to an institution providing PCS; second, the number of paediatric cardiac surgeons; third, this specialized procedure volume and its national distribution; and fourth, the 30-day perioperative mortality rate after PCS in Colombia. RESULTS Geospatial mapping approximates 64% (n = 9 894 356) of the under-18 Colombian population lives within 2-h drivetime of an institution providing PCS. Twenty-eight cardiovascular surgeons report performing PCS, 82% (n = 23) with formal training. In 2016, 1281 PCS procedures were registered, 90% of whom were performed in 6 of the country’s 32 departments. National non-risk-adjusted all-cause 30-day perioperative mortality rate after PCS was 2.73% (n = 35). CONCLUSIONS Colombia’s paediatric population had variable access to cardiac surgery in 2016, largely dependent upon geography. While the country may have the capacity to provide timely, high-quality care to those who need it, our study enables future comparative analyses to measure the impact of health system interventions facilitating healthcare equity for the underserved populations across Colombia and the Latin American region.

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Breaking the bottle neck to enhance pediatrics renal transplantation at Soba university hospital: Role of a non-governmental organization

Healthcare in Low-resource Settings ◽

10.4081/hls.2019.7930 ◽

2019 ◽

Vol 7 (1) ◽

Author(s):

Ihab B. Abdalrahman ◽

Shaima N. Elgenaid ◽

Rashid Ellidir ◽

Asma Nizar Mohammed Osman Abdallah ◽

Safa Ahmed Hassan Hamid ◽

...

Keyword(s):

Renal Transplant ◽

Quality Care ◽

Healthcare Delivery ◽

University Hospital ◽

Healthcare Delivery System ◽

Governmental Organization ◽

Low Resource ◽

Number Of Patients ◽

Stage Renal Disease ◽

The Impact

High cost and limited resources of pediatrics renal transplant in low-resource countries limits the number of transplants. However, the collaboration between government and community sector provided high quality care for these patients. Here we highlight the impact of a non-governmental organization in facilitating pediatrics renal transplant. Data was collected from files of all pediatric patients withend stage renal disease who received renal transplant between January 2010 and December 2017 at Soba University Hospital (77 patients). The 8-year period was divided into 16 intervals of 6 months each. The number of patients who received renal transplant ranged from 1 to 12 patients in each interval. There was a rise in 2017 when 21 (28.7%) patients received kidney transplant. In the last 6 months in 2017 there was a significant reduction in duration of hospital stay compared to the rest of the period; it dropped from 16.36 to 9.92 days (P=0.003). Partnership between governmental and non-governmental sectors is a good strategy in low resource area to bridge some of the gaps of healthcare delivery system.

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Successful outcome in acute gastric volvulus in a low resource hospital setting in Bangladesh: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2020.06.006 ◽

2020 ◽

Vol 72 ◽

pp. 443-447

Author(s):

Bappy Basak ◽

M. Tasdik Hasan ◽

Jessica Stauber ◽

Amit Sen Gupta ◽

Safiqul Islam ◽

...

Keyword(s):

Case Report ◽

Gastric Volvulus ◽

Hospital Setting ◽

Successful Outcome ◽

Low Resource ◽

Acute Gastric Volvulus

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Monitoring and evaluating surgical care: defining perioperative mortality rate and standardising data collection

The Lancet ◽

10.1016/s0140-6736(15)60822-4 ◽

2015 ◽

Vol 385 ◽

pp. S27 ◽

Cited By ~ 12

Author(s):

Charlotta L Palmqvist ◽

Roshan Ariyaratnam ◽

David A Watters ◽

Grant L Laing ◽

Douglas Stupart ◽

...

Keyword(s):

Mortality Rate ◽

Data Collection ◽

Surgical Care ◽

Perioperative Mortality

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NICU OUTCOME IN A LOW RESOURCE TEACHING HOSPITAL SETTING

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/1771 ◽

2013 ◽

Vol 2 (52) ◽

pp. 10305-10309

Author(s):

Sunil B ◽

Adarsh E ◽

Sahana G ◽

Prema R ◽

Tamil Selvan ◽

...

Keyword(s):

Teaching Hospital ◽

Hospital Setting ◽

Low Resource

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The Introduction and Experiences of Methadone for Treatment of Cancer Pain at a Low-resource Governmental Cancer Center in India

Indian Journal of Palliative Care ◽

10.25259/ijpc_383_20 ◽

2021 ◽

Vol 0 ◽

pp. 1-23

Author(s):

Gayatri Palat ◽

Charlotte Algotsson ◽

Spandana Rayala ◽

Maria Gebre-Medhin ◽

Eva Brun ◽

...

Keyword(s):

Cancer Pain ◽

Health Care Professionals ◽

Economic Status ◽

Hospital Setting ◽

Cancer Center ◽

Cancer Pain Management ◽

Care Environment ◽

Low Resource ◽

Patients With Cancer ◽

Conventional Content Analysis

Objectives: This study aimed to describe the clinical experience of the health-care professionals (HCPs) responsible for the introduction of methadone, for the treatment of complex cancer pain, at a low-resource hospital in India in a patient-group, burdened by illiteracy, and low socio-economic status. Materials and Methods: Ten HCPs: Four medical doctors, four nurses, one pharmacist, and one hospital administrator were interviewed. The interviews are examined using a qualitative conventional content analysis. Results: The interviews showed a confidence amongst the HCPs, responsible for the safe introduction of methadone in a stressful and low-resource surrounding, to patients with cancer pain and the different aspects of methadone, as initiation, titration, and maintenance of treatment. Conclusion: Introduction of methadone for cancer pain management is safe and feasible although low resources in a challenging hospital setting and care environment.

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Pediatric Perioperative Mortality in Kenya

Anesthesiology ◽

10.1097/aln.0000000000003070 ◽

2020 ◽

Vol 132 (3) ◽

pp. 452-460 ◽

Cited By ~ 3

Author(s):

Mark W. Newton ◽

Savannah E. Hurt ◽

Matthew D. McEvoy ◽

Yaping Shi ◽

Matthew S. Shotwell ◽

...

Keyword(s):

Mortality Rate ◽

Pediatric Surgery ◽

Surgical Care ◽

Perioperative Mortality ◽

Middle Income ◽

Factors Associated ◽

Safe Surgery ◽

Low Middle Income Countries ◽

Care Systems ◽

Data Elements

Abstract Background The global surgery access imbalance will have a dramatic impact on the growing population of the world’s children. In regions of the world with pediatric surgery and anesthesia manpower deficits and pediatric surgery–specific infrastructure and supply chain gaps, this expanding population will present new challenges. Perioperative mortality rate is an established indicator of the quality and safety of surgical care. To establish a baseline pediatric perioperative mortality rate and factors associated with mortality in Kenya, the authors designed a prospective cohort study and measured 24-h, 48-h, and 7-day perioperative mortality. Methods The authors trained anesthesia providers to electronically collect 132 data elements for pediatric surgical cases in 24 government and nongovernment facilities at primary, secondary, and tertiary hospitals from January 2014 to December 2016. Data assistants tracked all patients to 7 days postoperative, even if they had been discharged. Adjusted analyses were performed to compare mortality among different hospital levels after adjusting for prespecified risk factors. Results Of 6,005 cases analyzed, there were 46 (0.8%) 24-h, 62 (1.1%) 48-h, and 77 (1.7%) 7-day cumulative mortalities reported. In the adjusted analysis, factors associated with a statistically significant increase in 7-day mortality were American Society of Anesthesiologists Physical Status of III or more, night or weekend surgery, and not having the Safe Surgery Checklist performed. The 7-day perioperative mortality rate is less in the secondary (1.4%) and tertiary (2.4%) hospitals when compared with the primary (3.7%) hospitals. Conclusions The authors have established a baseline pediatric perioperative mortality rate that is greater than 100 times higher than in high-income countries. The authors have identified factors associated with an increased mortality, such as not using the Safe Surgery Checklist. This analysis may be helpful in establishing pediatric surgical care systems in low–middle income countries and develop research pathways addressing interventions that will assist in decreasing mortality rate. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

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Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03343-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Francesco Cavallin ◽

Serena Calgaro ◽

Valentina Brugnolaro ◽

Amir Hussein Abubacar Seni ◽

Arlindo Rosario Muhelo ◽

...

Keyword(s):

Mortality Rate ◽

Temperature Change ◽

Multivariable Analysis ◽

Thermal Control ◽

Forest Plot ◽

Moderate Hypothermia ◽

Low Resource ◽

Resource Setting ◽

Low Resource Setting ◽

The Relationship

Abstract Background Thermal control after birth is an essential part of neonatal care. However, the relationship between neonatal temperature at and after admission is unknown. This study aimed to evaluate the change between neonatal temperature at admission and at day 1, and its impact on mortality. Methods Retrospective observational study at the Beira Central Hospital, Mozambique. Axillary temperatures were recorded at admission and at day 1 in 1,226 neonates who were admitted to the Special Care Unit between January 1 and December 31, 2017. The relationship between mortality rate and temperature change was evaluated with a matrix plot and a forest plot (obtained from a logistic regression model as odds ratios with 95% confidence intervals). Results Normothermia was found in 415 neonates (33.8%) at admission and in 638 neonates (52.0%) at day 1. Mortality rate was highest in (i) neonates who remained in severe/moderate hypothermia (74%), (ii) neonates who rewarmed from hypothermia (40–55%), and (iii) neonates who chilled to severe/moderate hypothermia (38–43%). Multivariable analysis confirmed that temperature change from admission to day 1 was an independent predictor of mortality (p < 0.0001). Conclusions In a low-resource setting, one out of three neonates was found hypothermic at day 1 irrespectively of admission temperature. Relevant thermal deviations occurred in a high proportion of newborns with normothermia at admission. Being cold at admission and becoming cold or hyperthermic at day 1 were associated with increased likelihood of mortality. Appropriate actions to prevent both hypothermia and hyperthermia represent both a challenge and a priority during postnatal period.

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