Abstract:
BACKGROUND:Critical illness disproportionately affects people in low-income countries (LICs). Efforts to improve critical care in LICs must account for differences in demographics and infrastructure compared to high-income settings. Part of this effort includes the development and validation of intensive care unit (ICU) risk stratification models feasible for use in LICs. The purpose of this study was to validate and compare the performance of ICU mortality models developed for use in sub-Saharan Africa. MATERIALS AND METHODS:This was a prospective, observational cohort study of ICU patients in a referral hospital in Malawi. Models were selected for comparison based on a Medline search for studies which developed ICU mortality models based on cohorts in sub-Saharan Africa. Model discrimination was evaluated using the area under the curve with 95% confidence intervals (CI). RESULTS:During the study, 499 patients were admitted to the study ICU, and after exclusions, there were 319 patients. The cohort was 62% female, with the mean age 31 years (IQR: 23-41), and 74% had surgery preceding ICU admission. Discrimination for hospital mortality ranged from 0.54 (95% CI 0.48, 0.60) for the Universal Vital Assessment (UVA) to 0.72 (95% CI 0.66, 0.78) for the Malawi Intensive care Mortality Evaluation (MIME). After tenfold cross-validation, these results were unchanged. CONCLUSIONS:The MIME outperformed other models in this prospective study. Most ICU models developed for LICs had poor to modest discrimination for hospital mortality. Future research may contribute to a better risk stratification model for LICs by refining and enhancing the MIME.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Prin M,Pan S,Kadyaudzu C,Li G,Charles Adoi
10.1007/s00268-019-05078-9subject
Has Abstractpub_date
2019-10-01 00:00:00pages
2357-2364issue
10eissn
0364-2313issn
1432-2323pii
10.1007/s00268-019-05078-9journal_volume
43pub_type
杂志文章abstract:BACKGROUND:The aim of the present study was to evaluate the efficacy of cholestyramine ointment (15 %) in reducing postoperative pain at rest and during defecation after open hemorrhoidectomy. METHODS:A total of 91 patients with third and fourth degree hemorrhoids undergoing open hemorrhoidectomy were included in this...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1895-3
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:The impact of postoperative complications (POCs) on long-term survival outcomes following hepatic resection for colorectal liver metastasis (CRLM) is in controversy. The aim of the present meta-analysis was to systematically evaluate the POC effect on overall survival (OS) and disease-free survival (DFS) in ...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
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abstract::The radiological features of common benign conditions of the breast and the radiological procedures used in the investigation of benign breast disorders are presented. ...
journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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abstract:BACKGROUND:The role of lymphadenectomy in adrenocortical carcinoma resection is controversial. Therefore, we conducted a population-based study to assess the association between positive lymph nodes (LN) and survival. METHODS:The Surveillance, Epidemiology, and End Results set of cancer registries were utilized. The a...
journal_title:World journal of surgery
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doi:10.1007/s00268-020-05801-x
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abstract::During the three decades since the recognition of the Zollinger-Ellison syndrome (ZES), major progress has been made in the diagnosis and treatment of this disease. However, the many failed operations in patients with ZES, the existence of primary lymph node gastrinomas, and the surgical approach of patients with ZES ...
journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
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doi:10.1007/s00268-018-4698-3
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pub_type: 杂志文章
doi:10.1007/s00268-008-9766-7
更新日期:2008-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05008-9
更新日期:2019-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02066992
更新日期:1992-09-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1007/s00268-007-9043-1
更新日期:2007-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05468-4
更新日期:2020-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6801-6
更新日期:2003-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9354-2
更新日期:2008-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1007/s002680010246
更新日期:2000-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02393582
更新日期:1980-01-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2013-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2020-05-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02071532
更新日期:1992-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2003-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-10-01 00:00:00
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更新日期:2021-02-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00