ArticleBJS open2019
Effect of in-hospital delays on surgical mortality for emergency general surgery conditions at a tertiary hospital in Malawi.
Article in BJS open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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.
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.
Who cites it
22 citing papers in PubMed, 37 citations in OpenAlex.
- Determinants of surgical management outcomes among adult patients with intestinal obstruction at Mzuzu central hospital, Malawi.BMC surgery · 2025Article
- Intussusception risk factors and outcomes in adult and elderly patients: analysis from the national inpatient sample.Langenbeck's archives of surgery · 2025Article
- Surgeons' prioritization of emergency abdominal surgery and its impact on postoperative outcomes.Langenbeck's archives of surgery · 2025Article
- Age-stratified analysis of delayed fixation outcomes of femoral neck fracture among adults: A retrospective study at a tertiary care trauma center.The Journal of international medical research · 2025Article
- Transfusion and Mortality in Acute Care Surgical Patients in Malawi: A Propensity-Matched Analysis.The Journal of surgical research · 2024Article
- Surgical System Efficiency and Operative Productivity in Public and Private Health Facilities in Ethiopia: A Cross-Sectional Evaluation.Global health, science and practice · 2024Article
- Rectal Perforation Secondary to a Self-Administered Water-Hose Enema: A Case Report and Literature Review.Cureus · 2023Article
- Perioperative Risk Assessment in Humanitarian Settings: A Scoping Review.World journal of surgery · 2023Article
- Sex-Based Differences in Survival Among Patients with Acute Abdomen Undergoing Surgery in Malawi: A Propensity Weighted Analysis.World journal of surgery · 2023Article
- Potential Access to Emergency General Surgical Care in Ontario.International journal of environmental research and public health · 2022Article
- Inter-hospital Transfer Delays to a Tertiary Referral Center and Postoperative Outcomes in Patients with Abdominal Surgical Emergencies in Malawi.World journal of surgery · 2022Article
- Age Increases the Risk of Mortality by Four-Fold in Patients with Emergent Paralytic Ileus: Hospital Length of Stay, Sex, Frailty, and Time to Operation as Other Risk Factors.International journal of environmental research and public health · 2022Article
- Mortality audit in general surgery unit and lessons learned at a Nigerian tertiary hospital: a single centre observational study.The Pan African medical journal · 2022Observational
- Are Surgeons Enough? The Relationship between Increasing Surgical Demand and Access to Surgery in a Resource-Limited Environment.The Journal of surgical research · 2021Article
- The Association Between Burn Unit Census and Operative Intervention in a Resource-Limited Setting.World journal of surgery · 2021Article
- Assessment of Delays in Emergency Surgical Care and Patient Postoperative Outcomes at a Referral Hospital in Northern Rwanda.World journal of surgery · 2021Article
- Postoperative Complications and Risk of Mortality after Laparotomy in a Resource-Limited Setting.The Journal of surgical research · 2021Observational
- Management of liver trauma in urban university hospitals in India: an observational multicentre cohort study.World journal of emergency surgery : WJES · 2020Observational
- District General Hospital Surgical Capacity and Mortality Trends in Patients with Acute Abdomen in Malawi.World journal of surgery · 2020Article
- Characteristics of Intestinal Volvulus and Risk of Mortality in Malawi.World journal of surgery · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In sub-Saharan Africa, surgical access is limited by an inadequate surgical workforce, lack of infrastructure and decreased care-seeking by patients. Delays in treatment can result from delayed presentation (pre-hospital), delays in transfer (intrafacility) or after arrival at the treating centre (in-hospital delay; IHD). This study evaluated the effect of IHD on mortality among patients undergoing emergency general surgery and identified factors associated with IHD. Methods: Utilizing Malawi's Kamuzu Central Hospital Emergency General Surgery database, data were collected prospectively from September 2013 to November 2017. Included patients had a diagnosis considered to warrant urgent or emergency intervention for surgery. Bivariable analysis and Poisson regression modelling was done to determine the effect of IHD (more than 24 h) on mortality, and identify factors associated with IHD. Results: Of 764 included patients, 281 (36·8 per cent) had IHDs. After adjustment, IHD (relative risk (RR) 1·68, 95 per cent c.i. 1·01 to 2·78; Conclusion: IHDs were associated with increased mortality. Increased staffing levels and operating room availability at tertiary hospitals, especially at night, are needed.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.