Division of Global Surgery, University of Cape Town (UCT), Cape Town, South Africa.
College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
World J Surg. 2023 Jun;47(6):1387-1396. doi: 10.1007/s00268-023-06909-6. Epub 2023 Jan 19.
Perioperative registries can be utilised to track outcomes, develop risk prediction models, and make evidence-based decisions and interventions. To better understand and support initiatives to establish clinical registries, this study aimed to assess the indications, challenges, and characteristics of successful perioperative registries in low-resource settings, where there is unmet surgical demand and patients have a mortality rate up to double that of high-income countries. We conducted a librarian-assisted literature search of international research databases of articles published between January 1969 and January 2021. Studies were filtered using predefined criteria and responses to two Mixed Method Appraisal Tool screening questions. A Direct Content Analysis Method was used to synthesis. e data for eligible studies based on predefined criteria. The search identified 2793 abstracts. After removing duplicates and excluding studies that did not meet eligibility criteria, twelve studies were included, conducted in South America (n = 4), Africa (n = 5), the Middle East (n = 2), and Asia (n = 1). The lack of context-specific data for determining and evaluating patient outcomes (n = 7) was the major indication for implementation. Organising local research teams and engaging stakeholders in the host country were associated with successful implementation. Inadequate funding for data collectors and monitoring data quality were identified as challenges (n = 4). The goal of a perioperative registry is to generate data to influence and support quality improvement, and national surgical policies. Efforts to establish perioperative registries in low- and middle-income countries should engage local teams and stakeholders and seek to overcome challenges in data collection and monitoring.
围手术期注册可以用于跟踪结果、开发风险预测模型,并做出基于证据的决策和干预。为了更好地理解和支持在低资源环境中建立临床注册的举措,本研究旨在评估低资源环境中围手术期注册的适应症、挑战和特点,在这些地方,存在未满足的手术需求,患者的死亡率是高收入国家的两倍。我们对 1969 年 1 月至 2021 年 1 月期间发表的国际研究数据库中的文章进行了图书馆员辅助的文献检索。研究使用预定义标准进行筛选,并回答了混合方法评估工具的两个筛选问题。使用直接内容分析法,根据预定义标准综合合格研究的数据。该搜索确定了 2793 个摘要。在去除重复项并排除不符合资格标准的研究后,纳入了 12 项研究,这些研究分别在南美洲(n=4)、非洲(n=5)、中东(n=2)和亚洲(n=1)进行。缺乏用于确定和评估患者结局的特定于背景的数据(n=7)是实施的主要指征。组织当地研究团队并让利益相关者参与东道国的工作与成功实施相关。数据收集员的资金不足和数据质量监测不足被确定为挑战(n=4)。围手术期注册的目的是生成数据,以影响和支持质量改进以及国家手术政策。在中低收入国家建立围手术期注册应争取当地团队和利益相关者的参与,并努力克服数据收集和监测方面的挑战。