Evidence map›Paper›PMID 34799791›Full record

ArticleWorld journal of surgery2022

Surgical Safety Checklist Use and Post-Caesarean Sepsis in the Lake Zone of Tanzania: Results from Safe Surgery 2020.

Taylor Wurdeman, Steven J Staffa, David Barash, Ladislaus Buberwa, Eliudi Eliakimu, Erastus Maina, Sarah Maongezi, John G Meara, William Munyonyela, Rahma Mushi and 7 more

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 25% 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

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

  1. Pooled it
  2. 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

17 authors at 12 institutions in 2 countries.

Taylor Wurdeman *Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA. Taylor.wurdeman@gmail.com.ORCID 0000-0002-1806-9263
Steven J Staffa *Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
David BarashGE Foundation, Boston, MA, USA.
Ladislaus BuberwaSt. Josephs Hospital, Kagondo, Kagera, Tanzania.
Eliudi EliakimuGender, Elderly and Children, Ministry of Health, Community Development, Dodoma, Tanzania.
Erastus MainaD-Implement, Dalberg Advisors, Nairobi, Kenya.
Sarah MaongeziGender, Elderly and Children, Ministry of Health, Community Development, Dodoma, Tanzania.
John G MearaProgram in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
William MunyonyelaNyamiaga Hospital, Ngara, Kagera, Tanzania.
Rahma MushiDepartment of Obstetrics and Gynecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Cheri ReynoldsAssist International, Ripon, USA.
Christopher StraderProgram in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
John VaralloJHPIEGO, Baltimore, MD, USA.
Leonard WashingtonDepartment of Surgery, Bugando Medical Centre, Mwanza, Tanzania.
David ZurakowskiDepartment of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Shehnaz Alidina *Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
Ntuli A Kapologwe *President's Office, Regional Administration and Local Government, Dodoma, Tanzania.
Boston Children's Hospital · USHarvard University · USMinistry of Health, Community Development, Gender, Elderly and Children · TZAga Khan Hospital Dar es Salaam · TZBoston Foundation · USBugando Medical Centre · TZHealthcentric Advisors · USLoma Linda University Medical Center · USMuhimbili University of Health and Allied Sciences · TZRipon College · USSt. Joseph University In Tanzania · TZUniversity of Baltimore · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMaternal sepsis accounts for significant morbidity and mortality in lower income countries, and caesarean delivery, while often necessary, augments the risk of maternal sepsis. The aim of this study was to investigate the effect of Safe Surgery 2020 surgical safety checklist (SSC) implementation on post-caesarean sepsis in Tanzania.

methodsWe conducted a study in 20 facilities in Tanzania's Lake Zone as part of the Safe Surgery 2020 intervention. We prospectively collected data on SSC adherence and maternal sepsis outcomes from 1341 caesarian deliveries. The primary outcome measure was maternal sepsis rate. The primary predictor was SSC adherence. Multivariable logistic regression was used to estimate independent associations between SSC adherence and maternal sepsis.

resultsHigher SSC adherence was associated with lower rates of maternal sepsis (<25% adherence: 5.0%; >75% adherence: 0.7%). Wound class and facility type were significantly associated with development of maternal sepsis (Wound class: Clean-Contaminated 3.7%, Contaminated/Dirty 20%, P = 0.018) (Facility Type: Health Centre 5.9%, District Hospital 4.5%, Regional Referral Hospital 1.7%, P = 0.018). In multivariable analysis, after controlling for wound class and facility type, higher SSC adherence was associated with lower rates of maternal sepsis, with an adjusted odds ratio of 0.17 per percentage point increase in SSC adherence (95% CI: 0.04, 0.79; P = 0.024).

conclusionsAdherence to the SSC may reduce maternal morbidity during caesarean delivery, reinforcing the assumption that surgical quality interventions improve maternal outcomes. Future studies should continue to explore additional synergies between surgical and maternal quality improvement.

Indexed as

ChecklistSepsisCesarean SectionFemaleHumansPregnancyQuality ImprovementTanzania

Identifiers

PMID34799791
OpenAlexW3213895057

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.