ArticleBMJ global health2018
Perioperative mortality rates in low-income and middle-income countries: a systematic review and meta-analysis.
Article in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 4 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Building Surgical Capacity in Resource-Limited Settings Through Innovative Laparoscopy Training: A Systematic Review of Educational Interventions.World journal of surgery · 2026Pooled it
- Primary palliative care in low- and middle-income countries: A systematic review and thematic synthesis of the evidence for models and outcomes.Palliative medicine · 2024Pooled it
- The Impact of Quality Improvement Interventions in Improving Surgical Infections and Mortality in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis.World journal of surgery · 2021Pooled it
- Surgical Capacity in Rural Southeast Nigeria: Barriers and New Opportunities.Annals of global health · 2021Pooled it
- Epidemiology and risk factors of surgical site infections in elective surgeries in Pakistan (2022-2023): a multicentre, prospective cohort study from PakSurg 1.The Lancet regional health. Southeast Asia · 2026Article
- Epidemiology of children and adolescents undergoing surgery at Mexican public hospitals: a retrospective registry-based analysis from 2010 to 2022.BMC pediatrics · 2026Article
- Laparoscopic versus open appendectomy for acute appendicitis in Sub-Saharan Africa.Annals of medicine and surgery (2012) · 2026Article
- Article
- Prospective multi-centre analysis of rural trauma team development training for medical trainees and traffic law enforcement professionals in Uganda: an interrupted time series study.BMC medical education · 2025Article
- Transforming surgical care and safety: dissecting the impact of checklists in the global south.Frontiers in surgery · 2025Review
- Rural trauma team development training amongst medical trainees and traffic law enforcement professionals in a low-income country: a protocol for a prospective multicenter interrupted time series.International journal of surgery protocols · 2024Article
- Perioperative mortality in low-, middle-, and high-income countries: Protocol for a multi-level meta-regression analysis.PloS one · 2024Article
- Achieving Surgical, Obstetric, Trauma, and Anesthesia (SOTA) care for all in South Asia.Frontiers in public health · 2024Review
- Perioperative mortality of emergency and elective surgical patients in a low-income country: a single institution experience.Perioperative medicine (London, England) · 2023Article
- Laparoscopic cholecystectomy in a resource limited setting: Factors associated with difficult surgeries at the National Referral Hospital, Bhutan.Public health challenges · 2023Article
- Variation in postoperative outcomes of patients with intracranial tumors: insights from a prospective international cohort study during the COVID-19 pandemic.Neuro-oncology · 2023Article
- Evaluating the status of the Lancet Commission on Global Surgery indicators for India.The Lancet regional health. Southeast Asia · 2023Review
- Incidence and predictors of perioperative mortality in a low-resource country, Ethiopia: a prospective follow-up study.BMJ open · 2023Article
- Perioperative Risk Assessment in Humanitarian Settings: A Scoping Review.World journal of surgery · 2023Article
- Perioperative mortality among geriatric patients in Ethiopia: a prospective cohort study.Frontiers in medicine · 2023Article
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction
methodsWe did a systematic review of studies from LMICs published from 2009 to 2014 reporting POMR for any surgical procedure. We extracted select variables in duplicate from each included study and pooled estimates of POMR by type of procedure using random-effects meta-analysis of proportions and the Freeman-Tukey double arcsine transformation to stabilise variances.
resultsWe included 985 studies conducted across 83 LMICs, covering 191 types of surgical procedures performed on 1 020 869 patients. Pooled POMR ranged from less than 0.1% for appendectomy, cholecystectomy and caesarean delivery to 20%-27% for typhoid intestinal perforation, intracranial haemorrhage and operative head injury. We found no consistent associations between procedure-specific POMR and Human Development Index (HDI) or income-group apart from emergency peripartum hysterectomy POMR, which appeared higher in low-income countries. Inpatient mortality was the most commonly used definition, though only 46.2% of studies explicitly defined the time frame during which deaths accrued.
conclusionsEfforts to improve access to surgical care in LMICs should be accompanied by investment in improving the quality and safety of care. To improve the usefulness of POMR as a safety benchmark, standard reporting items should be included with any POMR estimate. Choosing a basket of procedures for which POMR is tracked may offer institutions and countries the standardisation required to meaningfully compare surgical outcomes across contexts and improve population health outcomes.
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