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Perioperative Risk Assessment in Humanitarian Settings: A Scoping Review

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Abstract

Background

No validated perioperative risk assessment models currently exist for use in humanitarian settings. To inform the development of a perioperative mortality risk assessment model applicable to humanitarian settings, we conducted a scoping review of the literature to identify reports that described perioperative risk assessment in surgical care in humanitarian settings and LMICs.

Methods

We conducted a scoping review of the literature to identify records that described perioperative risk assessment in low-resource or humanitarian settings. Searches were conducted in databases including: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, World Health Organization Catalog, and Google Scholar.

Results

Our search identified 1582 records. After title/abstract and full text screening, 50 reports remained eligible for analysis in quantitative and qualitative synthesis. These reports presented data from over 37 countries from public, NGO, and military facilities. Data reporting was highly inconsistent: fewer than half of reports presented the indication for surgery; less than 25% of reports presented data on injury severity or prehospital data. Most elements of perioperative risk models designed for high-resource settings (e.g., vital signs, laboratory data, and medical comorbidities) were unavailable.

Conclusion

At present, no perioperative mortality risk assessment model exists for use in humanitarian settings. Limitations in consistency and quality of data reporting are a primary barrier, however, can be addressed through data-driven identification of several key variables encompassed by a minimum dataset. The development of such a score is a critical step toward improving the quality of care provided to populations affected by conflict and protracted humanitarian crises.

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References

  1. Khuri SF, Daley J, Henderson WG (2002) The comparative assessment and improvement of quality of surgical care in the department of veterans affairs. Arch Surg 137:20–27. https://doi.org/10.1001/archsurg.137.1.20

    Article  PubMed  Google Scholar 

  2. Ng-Kamstra JS, Arya S, Greenberg SLM et al (2018) Perioperative mortality rates in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Glob Health 3:e000810. https://doi.org/10.1136/bmjgh-2018-000810

    Article  PubMed  PubMed Central  Google Scholar 

  3. Copeland GP (2002) The POSSUM system of surgical audit. Arch Surg 137:15–19. https://doi.org/10.1001/archsurg.137.1.15

    Article  PubMed  Google Scholar 

  4. Hornor MA, Hoeft C, Nathens AB (2018) quality benchmarking in trauma: from the NTDB to TQIP. Curr Trauma Rep 4:160–169. https://doi.org/10.1007/s40719-018-0127-1

    Article  Google Scholar 

  5. Bilimoria KY, Liu Y, Paruch JL et al (2013) Development and evaluation of the universal ACS NSQIP surgical risk calculator: a decision aid and informed consent tool for patients and surgeons. J Am Coll Surg 217:833-842.e3. https://doi.org/10.1016/j.jamcollsurg.2013.07.385

    Article  PubMed  PubMed Central  Google Scholar 

  6. Wild H, Stewart BT, LeBoa C et al (2020) Epidemiology of injuries sustained by civilians and local combatants in contemporary armed conflict: an appeal for a shared trauma registry among humanitarian actors. World J Surg. https://doi.org/10.1007/s00268-020-05428-y

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kluyts H-L, le Manach Y, Munlemvo DM et al (2018) The ASOS surgical risk calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications. Br J Anaesth 121:1357–1363. https://doi.org/10.1016/j.bja.2018.08.005

    Article  PubMed  Google Scholar 

  8. Spence RT, Chang DC, Kaafarani HMA et al (2018) Derivation, validation and application of a pragmatic risk prediction index for benchmarking of surgical outcomes. World J Surg 42:533–540. https://doi.org/10.1007/s00268-017-4177-2

    Article  PubMed  Google Scholar 

  9. Massaut J, Valles P, Ghismonde A et al (2017) The modified south African triage scale system for mortality prediction in resource-constrained emergency surgical centers: a retrospective cohort study. BMC Health Serv Res 17:594. https://doi.org/10.1186/s12913-017-2541-4

    Article  PubMed  PubMed Central  Google Scholar 

  10. Biccard BM, Madiba TE, Kluyts H-L et al (2018) Perioperative patient outcomes in the African surgical outcomes study: a 7-day prospective observational cohort study. Lancet 391:1589–1598. https://doi.org/10.1016/S0140-6736(18)30001-1

    Article  PubMed  Google Scholar 

  11. Davies JF, Lenglet A, van Wijhe M, Ariti C (2016) Perioperative mortality: analysis of 3 years of operative data across 7 general surgical projects of Médecins Sans Frontières in Democratic Republic of Congo, Central African Republic, and South Sudan. Surgery 159:1269–1278. https://doi.org/10.1016/j.surg.2015.12.022

    Article  PubMed  Google Scholar 

  12. Ndayizeye L, Ngarambe C, Smart B et al (2016) Peritonitis in Rwanda: epidemiology and risk factors for morbidity and mortality. Surgery 160:1645–1656. https://doi.org/10.1016/j.surg.2016.08.036

    Article  PubMed  Google Scholar 

  13. Rickard JL, Ntakiyiruta G, Chu KM (2016) Associations with perioperative mortality rate at a major referral hospital in Rwanda. World J Surg 40:784–790. https://doi.org/10.1007/s00268-015-3308-x

    Article  PubMed  Google Scholar 

  14. FactSheet13en.pdf

  15. World Bank Country and Lending Groups—World Bank Data Help Desk. https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. Accessed 14 Nov 2021

  16. Tricco AC, Lillie E, Zarin W et al (2018) PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 169:467–473. https://doi.org/10.7326/M18-0850

    Article  PubMed  Google Scholar 

  17. Peters MDJ, Marnie C, Tricco AC et al (2020) Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth 18:2119–2126. https://doi.org/10.11124/JBIES-20-00167

    Article  PubMed  Google Scholar 

  18. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (eds) (2019) Cochrane handbook for systematic reviews of interventions. John Wiley & Sons

  19. Marks IH, Fong ZV, Stapleton SM et al (2018) How much data are good enough? Using simulation to determine the reliability of estimating POMR for resource-constrained settings. World J Surg 42:2344–2347. https://doi.org/10.1007/s00268-018-4529-6

    Article  PubMed  Google Scholar 

  20. Burkle FM, Nickerson JW, von Schreeb J et al (2012) Emergency surgery data and documentation reporting forms for sudden-onset humanitarian crises, natural disasters and the existing burden of surgical disease. Prehosp Disaster Med 27:577–582. https://doi.org/10.1017/S1049023X12001306

    Article  PubMed  Google Scholar 

  21. Anderson GA, Ilcisin L, Abesiga L et al (2017) Surgical volume and postoperative mortality rate at a referral hospital in Western Uganda: measuring the lancet commission on global surgery indicators in low-resource settings. Surgery 161:1710–1719. https://doi.org/10.1016/j.surg.2017.01.009

    Article  PubMed  Google Scholar 

  22. AlWaqfi N, Khader Y, Ibrahim K (2012) Coronary artery bypass: predictors of 30-day operative mortality in Jordanians. Asian Cardiovasc Thorac Ann 20:245–251. https://doi.org/10.1177/0218492311434647

    Article  PubMed  Google Scholar 

  23. Ariyaratnam R, Palmqvist CL, Hider P et al (2015) Toward a standard approach to measurement and reporting of perioperative mortality rate as a global indicator for surgery. Surgery 158:17–26. https://doi.org/10.1016/j.surg.2015.03.024

    Article  PubMed  Google Scholar 

  24. Bunogerane GJ, Rickard J (2019) A cross sectional survey of factors influencing mortality in Rwandan surgical patients in the intensive care unit. Surgery 166:193–197. https://doi.org/10.1016/j.surg.2019.04.010

    Article  PubMed  Google Scholar 

  25. Harunani S, Imbaya K, Kuremu T (2020) Non-traumatic abdominal surgical emergencies in children. Ann Afr Surg 17:3–6

    Article  Google Scholar 

  26. Khan A, Abdullah A, Ahmad H et al (2017) Impact of international quality improvement collaborative on congenital heart surgery in Pakistan. Heart 103:1680–1686. https://doi.org/10.1136/heartjnl-2016-310533

    Article  PubMed  Google Scholar 

  27. Maine RG, Kajombo C, Purcell L et al (2019) Effect of in-hospital delays on surgical mortality for emergency general surgery conditions at a tertiary hospital in Malawi. BJS Open 3:367–375. https://doi.org/10.1002/bjs5.50152

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Mansourati M, Kumar V, Khajanchi M et al (2018) Mortality following surgery for trauma in an Indian trauma cohort. Br J Surg 105:1274–1282. https://doi.org/10.1002/bjs.10862

    Article  CAS  PubMed  Google Scholar 

  29. Rahman AS, Chao TE, Trelles M et al (2021) The effect of conflict on obstetric and non-obstetric surgical needs and operative mortality in fragile states. World J Surg 45:1400–1408. https://doi.org/10.1007/s00268-021-05972-1

    Article  PubMed  Google Scholar 

  30. Rahman S, Zheleva B, Cherian KM et al (2019) Linking world bank development indicators and outcomes of congenital heart surgery in low-income and middle-income countries: retrospective analysis of quality improvement data. BMJ Open 9:e028307. https://doi.org/10.1136/bmjopen-2018-028307

    Article  PubMed  PubMed Central  Google Scholar 

  31. Reddy NS, Kappanayil M, Balachandran R et al (2015) Preoperative determinants of outcomes of infant heart surgery in a limited-resource setting. Semin Thorac Cardiovasc Surg 27:331–338. https://doi.org/10.1053/j.semtcvs.2015.09.008

    Article  PubMed  Google Scholar 

  32. Schidlow DN, Jenkins KJ, Gauvreau K et al (2017) Transposition of the great arteries in the developing world: surgery and outcomes. J Am Coll Cardiol 69:43–51. https://doi.org/10.1016/j.jacc.2016.10.051

    Article  PubMed  PubMed Central  Google Scholar 

  33. Shanthamurthy D, Manesh A, Zacchaeus NG et al (2018) Perioperative outcomes in human immunodeficiency virus-infected patients—the PRO HIV study. Int J STD AIDS 29:968–973. https://doi.org/10.1177/0956462418764485

    Article  PubMed  Google Scholar 

  34. Sileshi B, Hurt SE, McEvoy MD et al (2016) Pediatric perioperative mortality rates in a sample of Kenyan hospitals: preliminary results in over 3000 cases. Ann Glob Health 82:434–435. https://doi.org/10.1016/j.aogh.2016.04.207

    Article  Google Scholar 

  35. Talabi AO, Etonyeaku AC, Sowande OA et al (2014) Predictors of mortality in children with typhoid ileal perforation in a Nigerian tertiary hospital. Pediatr Surg Int 30:1121–1127. https://doi.org/10.1007/s00383-014-3592-9

    Article  PubMed  Google Scholar 

  36. Talabi AO, Sowande OA, Adenekan AT et al (2018) A 10 year retrospective review of perioperative mortality in pediatric general surgery at Ile-Ife hospital, Nigeria. J Pediatr Surg 53:2072–2076. https://doi.org/10.1016/j.jpedsurg.2018.03.005

    Article  PubMed  Google Scholar 

  37. Tarekegn F, Asfaw G, Mossie M (2020) Perioperative mortality at Tibebe Ghion Specialized Teaching Hospital, Ethiopia: a longitudinal study design. Int J Surg Open 26:81–85. https://doi.org/10.1016/j.ijso.2020.08.011

    Article  Google Scholar 

  38. Tarekegn F, Seyoum R, Abebe G, Terefe M (2021) Perioperative pediatric mortality in Ethiopia: a prospective cohort study. Ann Med Surg (Lond) 67:102396. https://doi.org/10.1016/j.amsu.2021.102396

    Article  PubMed  Google Scholar 

  39. Torborg A, Cronje L, Thomas J et al (2019) South African Paediatric Surgical Outcomes Study: a 14-day prospective, observational cohort study of paediatric surgical patients. Br J Anaesth 122:224–232. https://doi.org/10.1016/j.bja.2018.11.015

    Article  CAS  PubMed  Google Scholar 

  40. Vashistha N, Singhal D, Budhiraja S et al (2018) Outcomes of emergency laparotomy (EL) care protocol at tertiary care center from low-middle-income country (LMIC). World J Surg 42:1278–1284. https://doi.org/10.1007/s00268-017-4333-8

    Article  PubMed  Google Scholar 

  41. Atashi A, Amini S, Tashnizi MA et al (2018) External validation of european system for cardiac operative risk evaluation II (EuroSCORE II) for risk prioritization in an Iranian population. Braz J Cardiovasc Surg 33:40–46. https://doi.org/10.21470/1678-9741-2017-0030

    Article  PubMed  PubMed Central  Google Scholar 

  42. Berger JH, Jiang Z, O’Reilly EB, Christman MS (2018) First do no harm: predicting surgical morbidity during humanitarian medical missions. World J Surg 42:3856–3860. https://doi.org/10.1007/s00268-018-4720-9

    Article  PubMed  Google Scholar 

  43. Biccard B, Nepaul S (2010) Risk factors associated with intermediate and long-term mortality following vascular surgery in South African patients. Cardiovasc J Afr 21:263–267. https://doi.org/10.5830/CVJA-2010-016

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Chardoli M, Rahimi-Movaghar V (2006) Analysis of trauma outcome at a university hospital in Zahedan, Iran using the TRISS method. East Afr Med J 83:440–442. https://doi.org/10.4314/eamj.v83i8.9458

    Article  CAS  PubMed  Google Scholar 

  45. Hariharan S, Chen D, Ramkissoon A et al (2009) Perioperative outcome of colorectal cancer and validation of CR-POSSUM in a Caribbean country. Int J Surg 7:534–538. https://doi.org/10.1016/j.ijsu.2009.08.009

    Article  PubMed  Google Scholar 

  46. Isbister WH, Al-Sanea N (2002) POSSUM: a re-evaluation in patients undergoing surgery for rectal cancer. The physiological and operative severity score for enumeration of mortality and morbidity. ANZ J Surg 72:421–425. https://doi.org/10.1046/j.1445-2197.2002.02436.x

    Article  PubMed  Google Scholar 

  47. Liebenberg JJ, Doubell A, Van Wyk J et al (2020) Predictors of 1 year survival in South African transcatheter aortic valve implant candidates. S Afr Med J 110:491–496. https://doi.org/10.7196/SAMJ.2020.v110i6.14123

    Article  CAS  PubMed  Google Scholar 

  48. Osinaike B, Ayandipo O, Onyeka T et al (2019) Nigerian surgical outcomes—Report of a 7-day prospective cohort study and external validation of the African surgical outcomes study surgical risk calculator. Int J Surg 68:148–156. https://doi.org/10.1016/j.ijsu.2019.06.003

    Article  PubMed  Google Scholar 

  49. Mohil RS, Bhatnagar D, Bahadur L et al (2004) POSSUM and P-POSSUM for risk-adjusted audit of patients undergoing emergency laparotomy. Br J Surg 91:500–503. https://doi.org/10.1002/bjs.4465

    Article  CAS  PubMed  Google Scholar 

  50. Sadeghi MM, Arasteh M, Gharipour M et al (2011) Evaluation of accuracy of Euroscore risk model in prediction of perioperative mortality after coronary bypass graft surgery in Isfahan. J Res Med Sci 16:787–792

    PubMed  PubMed Central  Google Scholar 

  51. Samuel JC, Varela C, Cairns BA, Charles AG (2014) Application of SIRS criteria to a paediatric surgical population in Malawi. J Trop Pediatr 60:326–328. https://doi.org/10.1093/tropej/fmu021

    Article  PubMed  PubMed Central  Google Scholar 

  52. Sileshi B, McEvoy MD, Wanderer JP et al (2015) Surgical Apgar score and safe surgery checklist use in Kenya: preliminary results of over 3000 cases at a single tertiary care center. Ann Glob Health 81:200–201. https://doi.org/10.1016/j.aogh.2015.02.961

    Article  Google Scholar 

  53. Srinath S (2013) Risk prediction of morbidity and mortality in emergency laparotomy by possum equation. Res J Pharm Biol Chem Sci 4:206

    Google Scholar 

  54. Muhrbeck M, Osman Z, von Schreeb J et al (2021) Predicting surgical resource consumption and in-hospital mortality in resource-scarce conflict settings: a retrospective study. BMC Emerg Med 21:1–11. https://doi.org/10.1186/s12873-021-00488-2

    Article  Google Scholar 

  55. Gutierrez CS, Passos SC, Castro SMJ et al (2021) Few and feasible preoperative variables can identify high-risk surgical patients: derivation and validation of the ex-care risk model. Br J Anaesth 126:525–532. https://doi.org/10.1016/j.bja.2020.09.036

    Article  PubMed  Google Scholar 

  56. Kluyts H-L, Conradie W, Cloete E et al (2021) Development of a clinical prediction model for in-hospital mortality from the South African Cohort of the African Surgical Outcomes Study. World J Surg 45:404–416. https://doi.org/10.1007/s00268-020-05843-1

    Article  PubMed  Google Scholar 

  57. Weeks SR, Juillard CJ, Monono ME et al (2014) Is the Kampala trauma score an effective predictor of mortality in low-resource settings? A comparison of multiple trauma severity scores. World J Surg 38:1905–1911. https://doi.org/10.1007/s00268-014-2496-0

    Article  PubMed  Google Scholar 

  58. Long C, Esquivel MM, Uribe-Leitz T et al (2016) Lessons learned from implementing a hospital-based trauma registry in rural Cameroon. Ann Glob Health 82:535–536. https://doi.org/10.1016/j.aogh.2016.04.447

    Article  Google Scholar 

  59. Sileshi B, Newton MW, Kiptanui J et al (2017) Monitoring anesthesia care delivery and perioperative mortality in Kenya utilizing a provider-driven novel data collection tool. Anesthesiology 127:250–271. https://doi.org/10.1097/ALN.0000000000001713

    Article  PubMed  Google Scholar 

  60. Croti UA, Murakami AN, De Marchi CH et al (2019) Impact of partnership between children’s HeartLink and IQIC database with a pediatric cardiology and cardiovascular surgery center in Brazil. World J Pediatr Congenit Heart Surg 10:270–275. https://doi.org/10.1177/2150135118825151

    Article  PubMed  Google Scholar 

  61. Watters DA, Hollands MJ, Gruen RL et al (2015) Perioperative mortality rate (POMR): a global indicator of access to safe surgery and anaesthesia. World J Surg 39:856–864. https://doi.org/10.1007/s00268-014-2638-4

    Article  PubMed  Google Scholar 

  62. Bruijns SR, Guly HR, Bouamra O et al (2013) The value of traditional vital signs, shock index, and age-based markers in predicting trauma mortality. J Trauma Acute Care Surg 74:1432–1437. https://doi.org/10.1097/TA.0b013e31829246c7

    Article  PubMed  Google Scholar 

  63. Liu NT, Holcomb JB, Wade CE, Salinas J (2015) Improving the prediction of mortality and the need for life-saving interventions in trauma patients using standard vital signs with heart-rate variability and complexity. Shock 43:549–555. https://doi.org/10.1097/SHK.0000000000000356

    Article  PubMed  Google Scholar 

  64. Dotan I, Shochat T, Shimon I, Akirov A (2021) The association between BMI and mortality in surgical patients. World J Surg 45:1390–1399. https://doi.org/10.1007/s00268-021-05961-4

    Article  PubMed  Google Scholar 

  65. Gibbs J, Cull W, Henderson W et al (1999) Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the national VA surgical risk study. Arch Surg 134:36–42. https://doi.org/10.1001/archsurg.134.1.36

    Article  CAS  PubMed  Google Scholar 

  66. Holcomb JB, Salinas J, McManus JM et al (2005) Manual vital signs reliably predict need for life-saving interventions in trauma patients. J Trauma Acute Care Surg 59:821–829. https://doi.org/10.1097/01.ta.0000188125.44129.7c

    Article  Google Scholar 

  67. Theou O, Andrew M, Ahip SS et al (2019) The pictorial fit-frail scale: developing a visual scale to assess frailty. Can Geriatr J 22:64–74. https://doi.org/10.5770/cgj.22.357

    Article  PubMed  PubMed Central  Google Scholar 

  68. Eastridge BJ, Mabry RL, Seguin P et al (2012) Death on the battlefield (2001–2011): implications for the future of combat casualty care. J Trauma Acute Care Surg 73:S431-437. https://doi.org/10.1097/TA.0b013e3182755dcc

    Article  PubMed  Google Scholar 

  69. Wild H, Stewart BT, LeBoa C et al (2021) Pediatric casualties in contemporary armed conflict: a systematic review to inform standardized reporting. Injury 52:1748–1756. https://doi.org/10.1016/j.injury.2021.04.055

    Article  PubMed  Google Scholar 

  70. Nashef SA, Roques F, Michel P et al (1999) European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg 16:9–13. https://doi.org/10.1016/s1010-7940(99)00134-7

    Article  CAS  PubMed  Google Scholar 

  71. Copeland GP, Jones D, Walters M (1991) POSSUM: a scoring system for surgical audit. Br J Surg 78:355–360. https://doi.org/10.1002/bjs.1800780327

    Article  CAS  PubMed  Google Scholar 

  72. Brooks MJ, Sutton R, Sarin S (2005) Comparison of surgical risk score, POSSUM and p-POSSUM in higher-risk surgical patients. Br J Surg 92:1288–1292. https://doi.org/10.1002/bjs.5058

    Article  CAS  PubMed  Google Scholar 

  73. Schluter PJ, Nathens A, Neal ML et al (2010) Trauma and injury severity score (TRISS) coefficients 2009 revision. J Trauma Acute Care Surg 68:761–770. https://doi.org/10.1097/TA.0b013e3181d3223b

    Article  Google Scholar 

  74. Hannan EL, Mendeloff J, Farrell LS et al (1995) Validation of TRISS and ASCOT using a non-MTOS trauma registry. J Trauma 38:83–88. https://doi.org/10.1097/00005373-199501000-00022

    Article  CAS  PubMed  Google Scholar 

  75. van Gennip L, Haverkamp FJC, Muhrbeck M et al (2020) Using the Red Cross wound classification to predict treatment needs in children with conflict-related limb injuries: a retrospective database study. World J Emerg Surg 15:52. https://doi.org/10.1186/s13017-020-00333-0

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA

    Hannah Wild, Barclay T. Stewart & Kajal Mehta

  2. Global Injury Control Section, Harborview Injury Prevention and Research Center, Seattle, WA, USA

    Barclay T. Stewart

  3. Department of Environmental Health Sciences, University of California Berkeley, Berkeley, CA, USA

    Christopher LeBoa

  4. Health Science Library, University of Washington, Seattle, WA, USA

    Teresa Jewell

  5. Stanford University School of Medicine, Stanford, CA, USA

    Sherry M. Wren

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Wild, H., Stewart, B.T., LeBoa, C. et al. Perioperative Risk Assessment in Humanitarian Settings: A Scoping Review. World J Surg 47, 1092–1113 (2023). https://doi.org/10.1007/s00268-023-06893-x

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