Evidence map›Paper›PMID 27738833›Full record

ArticleWorld journal of surgery2017

Measuring the Burden of Surgical Disease Averted by Emergency and Essential Surgical Care in a District Hospital in Papua New Guinea.

Matthew A R Stokes, Glenn D Guest, Perista Mamadi, Westin Seta, Noel Yaubihi, Grace Karawiga, Billy Naidi, David A K Watters

Open access · hybridAbstract read
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In one paragraph

Article in World journal of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 18% of its field
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Article
  5. Article
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  7. 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

8 authors at 3 institutions in 2 countries.

Matthew A R StokesSchool of Medicine, Deakin University, Kings Way, Waurn Ponds, VIC, 3216, Australia. marstokes@gmail.com.
Glenn D GuestSchool of Medicine, Deakin University, Kings Way, Waurn Ponds, VIC, 3216, Australia.
Perista MamadiAlotau General Hospital, PO Box 402, Alotau, Milne Bay Province, Papua New Guinea.
Westin SetaAlotau General Hospital, PO Box 402, Alotau, Milne Bay Province, Papua New Guinea.
Noel YaubihiAlotau General Hospital, PO Box 402, Alotau, Milne Bay Province, Papua New Guinea.
Grace KarawigaAlotau General Hospital, PO Box 402, Alotau, Milne Bay Province, Papua New Guinea.
Billy NaidiAlotau General Hospital, PO Box 402, Alotau, Milne Bay Province, Papua New Guinea.
David A K WattersSchool of Medicine, Deakin University, Kings Way, Waurn Ponds, VIC, 3216, Australia. watters.david@gmail.com.
American Occupational Therapy Association · USGeelong Hospital · AUDeakin University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely access to emergency and essential surgical care (EESC) and anaesthesia in low- and middle-income countries (LMICs) prevents premature death, minimises lifelong disability and reduces their economic impact on families and communities. Papua New Guinea is one of the poorest countries in the Pacific region, and provides much of its surgical care at a district hospital level. We aimed to evaluate the surgical capacity of a district hospital in PNG and estimate the effectiveness of surgical interventions provided.

methodsWe performed a prospective study to calculate the number of DALYs averted for 465 patients treated with surgical care over a 3-month period (Sep-Nov 2013) in Alotau Hospital, Milne Bay Province, PNG (pop 210,000). Data were also collected on infrastructure, workforce, interventions provided and equipment available using the World Health Organization's Integrated Management of Emergency and Essential Surgical Care Toolkit, a survey to assess EESC and surgical capacity. We also performed a retrospective one-year audit of surgical, obstetric and anaesthetic care to provide context with regards to annual disease burden treated and surgical activity.

resultsEESC was provided by 11 Surgeons/Anaesthetists/Obstetricians (SAO) providers, equating to 5.7 per 100,000 population (including 4 nurse anaesthetists). They performed 783/100,000 procedures annually. Over the 3-month prospective study period, 4954 DALYs were averted by 465 surgical interventions, 52 % of which were elective. This equates to 18,330 DALYs averted annually or, approximately 18 % of the published but estimated disease burden in the Province in the 2013 Global Burden of Disease Study. The overall peri-operative mortality rate was 1.29 %, with 0.41 % for elective procedures and 2.25 % for emergencies.

conclusionsMuch of the burden of surgical disease in Papua New Guinea presenting to Alotau General Hospital serving Milne Bay Province can be effectively treated by a small team providing emergency and essential surgical care. This is despite a relatively low surgical volume and limited numbers of trained surgical anaesthesia obstetric providers, and likely underservicing. The ability of surgical care to avert disease in Papua New Guinea highlights its importance to public health in LMICs.

Indexed as

Health Services AccessibilityAdolescentAdultChildDeveloping CountriesElective Surgical ProceduresEmergenciesFemaleHealth WorkforceHospitals, DistrictHumansMaleMedical AuditMiddle AgedPapua New GuineaPregnancy

Identifiers

PMID27738833
OpenAlexW2531672001

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.