Evidence map›Paper›PMID 26869519›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2017

Patterns of surgical presentation at an African regional referral hospital: surveillance as a step towards improving access to care.

M M Ajiko, D Davé, I Feldhaus, R N Smith, C Juillard, R A Dicker

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

M M AjikoSoroti Regional Referral Hospital, Soroti-Lira Rd, Soroti, Uganda.
D DavéDepartment of Surgery, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, USA.
I FeldhausDepartment of Surgery, Center for Global Surgical Studies, University of California, San Francisco, 1001 Potrero Avenue, Ward 3A Box 0807, San Francisco, CA, USA.
R N SmithDepartment of Surgery, Penn Presbyterian Medical Center, University of Pennsylvania, 51 N 39th St., Philadelphia, PA, USA.
C JuillardDepartment of Surgery, Center for Global Surgical Studies, University of California, San Francisco, 1001 Potrero Avenue, Ward 3A Box 0807, San Francisco, CA, USA.
R A DickerDepartment of Surgery, Center for Global Surgical Studies, University of California, San Francisco, 1001 Potrero Avenue, Ward 3A Box 0807, San Francisco, CA, USA. rochelle.dicker@ucsf.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical disease is being increasingly recognized as a significant health burden in Africa. Efforts have been made to describe surgical disease and capacity at the district hospital level. Little is known about patterns seen at regional hospitals supporting the district hospital network.

methodsThis retrospective study was conducted at Uganda's Soroti Regional Referral Hospital, serving eight districts. Data were collected from July 2010 to March 2012 using operative and inpatient records as available. Univariate and bivariate analyses were performed to explore patterns of procedures performed and in-patient diagnoses.

resultsThere were 8511 procedures recorded in the operative log between July 2010 and June 2011, averaging 709 per month. Caesarian sections (41 %), dilation and evacuations (28 %), and laparotomies (19 %) were most frequent. Referrals to Soroti averaged 260 per month, while transfers out averaged 5 patients per month. Inpatient records documented 2949 surgically related diagnoses between July 2010 and May 2011. In patients >4 years old, 21 % of mortality was due to surgical disease, 29 % of which was trauma-related. Women comprised 80 % of violent injury. Common hospital record elements, such as demographic data, important clinical information, and operative notes were absent from these data sources.

conclusionsThe World Health Assembly recently recognized strengthening of first referral hospitals as a crucial element to achieving universal health coverage. Inconsistencies in recordkeeping despite the large volume of surgical disease suggest that sustainable surveillance systems and capacity building at the referral hospital level are potential building blocks to improving access to surgical care.

Indexed as

Health Services ResearchAge DistributionChild, PreschoolDeveloping CountriesFemaleHealth Services AccessibilityHealth Services Needs and DemandHospitals, DistrictHospitals, RuralHumansInfantInfant, NewbornMaleReferral and ConsultationRetrospective StudiesSurgery Department, HospitalHospital recordsHospital referralRetrospective reviewSurgerySurgical diseaseUganda

Identifiers

PMID26869519

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.