PMID- 32419325
OWN - NLM
STAT- MEDLINE
DCOM- 20210429
LR  - 20210429
IS  - 1445-2197 (Electronic)
IS  - 1445-1433 (Linking)
VI  - 90
IP  - 10
DP  - 2020 Oct
TI  - How will increasing surgical volume affect mortality in the Pacific, Papua New 
      Guinea and Timor Leste?
PG  - 1915-1919
LID - 10.1111/ans.15989 [doi]
AB  - BACKGROUND: Nine South Pacific nations, Papua New Guinea and Timor Leste, have 
      collaborated to report and publish their surgical metrics as recommended by the 
      Lancet Commission on Global Surgery (LCoGS). Currently, these countries 
      experience about 750 postoperative deaths per year, representing 1% of crude 
      mortality in the region. Given that more than 400 000 annual procedures are 
      needed in the nine nations to reach the LCoGS target of 5000/100 000, we aimed to 
      calculate the potential contribution of perioperative mortality to national 
      mortality where these procedures are performed. METHODS: We utilized reported 
      surgical metrics with current rates for surgical volume (SV) and perioperative 
      mortality (POMR), as well as World Bank/WHO mortality statistics, to predict the 
      likely impact of surgical scale-up to recommended targets by 2030. We tested 
      correlations between SV and POMR in countries from our region using Pearson's r 
      statistic. Funnel plots were used to evaluate the dataset for outliers. RESULTS: 
      Surgical scale up would result in perioperative mortality contributing on average 
      to 3.3% of all national crude mortality. This prediction assumes POMR stays the 
      same, which is challenging to predict. In our region countries that achieved the 
      LCoGS target (n = 5) had a lower POMR than countries that did not (n = 8). 
      CONCLUSIONS: Surgical volumes in the South Pacific region must increase to meet 
      the LCoGS target. Postoperative mortality as a proportion of all mortality may 
      increase with the surgical scale up, however, the overall number of premature 
      deaths is expected to reduce with better access to timely and safe surgical care.
CI  - (c) 2020 Royal Australasian College of Surgeons.
FAU - Nagra, Sonal
AU  - Nagra S
AUID- ORCID: 0000-0003-0562-9433
AD  - Deakin University, Melbourne, Victoria, Australia.
AD  - Barwon Health, Melbourne, Victoria, Australia.
FAU - Kaur, Balbindar
AU  - Kaur B
AD  - Barwon Health, Melbourne, Victoria, Australia.
FAU - Singh, Sheetal
AU  - Singh S
AD  - Ministry of Health, Wellington, New Zealand.
FAU - Tangi, Viliame
AU  - Tangi V
AD  - Nuku'alofa Hospital, Nuku'alofa, Tonga.
FAU - Mccaig, Eddie
AU  - Mccaig E
AD  - Fiji National University, Suva, Fiji.
FAU - Stupart, Douglas
AU  - Stupart D
AD  - Deakin University, Melbourne, Victoria, Australia.
AD  - Barwon Health, Melbourne, Victoria, Australia.
FAU - Moore, Eileen M
AU  - Moore EM
AUID- ORCID: 0000-0002-0097-4740
AD  - Deakin University, Melbourne, Victoria, Australia.
AD  - Barwon Health, Melbourne, Victoria, Australia.
FAU - Meara, John G
AU  - Meara JG
AD  - Harvard University, Boston, MA, USA.
FAU - Guest, Glenn D
AU  - Guest GD
AD  - Deakin University, Melbourne, Victoria, Australia.
AD  - Barwon Health, Melbourne, Victoria, Australia.
FAU - Watters, David A
AU  - Watters DA
AUID- ORCID: 0000-0002-5742-8417
AD  - Deakin University, Melbourne, Victoria, Australia.
AD  - Barwon Health, Melbourne, Victoria, Australia.
LA  - eng
PT  - Journal Article
DEP - 20200517
PL  - Australia
TA  - ANZ J Surg
JT  - ANZ journal of surgery
JID - 101086634
SB  - IM
MH  - Humans
MH  - Papua New Guinea/epidemiology
MH  - *Postoperative Complications/mortality
MH  - *Surgical Procedures, Operative/mortality
MH  - Timor-Leste/epidemiology
OTO - NOTNLM
OT  - General surgery
OT  - Global Health
OT  - Universal access to surgery
EDAT- 2020/05/19 06:00
MHDA- 2021/04/30 06:00
CRDT- 2020/05/19 06:00
PHST- 2019/09/27 00:00 [received]
PHST- 2020/04/12 00:00 [revised]
PHST- 2020/04/23 00:00 [accepted]
PHST- 2020/05/19 06:00 [pubmed]
PHST- 2021/04/30 06:00 [medline]
PHST- 2020/05/19 06:00 [entrez]
AID - 10.1111/ans.15989 [doi]
PST - ppublish
SO  - ANZ J Surg. 2020 Oct;90(10):1915-1919. doi: 10.1111/ans.15989. Epub 2020 May 17.