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国际任务对坦桑尼亚贾卡亚·基奎特心脏研究所冠状动脉旁路移植术心脏服务提供及技能转移的影响

The Impact of International Missions in Provision of Cardiac Services and Skill Transfer in Respect to Coronary Artery Bypass Grafting at Jakaya Kikwete Cardiac Institute - Tanzania.

作者信息

Nyawawa Evarist T M, Mayala Henry A, Kisenge Peter R, Byomuganyizi Moses, Joseph Alex B, Muhozya Angela N, Khamis Ramadhan, Nyawawa Evans E, Nyangasa Juma B, Ncheye Adelphina, Loth Alex, Marath Aubyn

机构信息

Jakaya Kikwete Cardiac Institute, Dar es Salaam, United Republic of Tanzania.

Department of Cardiothoracic Surgery, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania.

出版信息

Braz J Cardiovasc Surg. 2025 May 5;40(3):e20240075. doi: 10.21470/1678-9741-2024-0075.

Abstract

OBJECTIVE

To assess how efficient the local team attained skills are after several visits made by international missions in respect to number of coronary artery bypass grafting surgery performed and the overall patient outcome.

METHODS

This was a retrospective study that included all patients who were operated on at the center after being diagnosed with chronic coronary artery disease from May 2016 to December 2023. Patients' demographic data were retrieved from patients' files coupled with theatre record file, entered into a structured questionnaire, and then, in a statistical program.

RESULTS

A total of 290 patients underwent coronary artery bypass grafting at the center. The international missions performed a total of 159 (54.8%) operations, while the local team operated a total of 131 (45.2%) patients. The study showed significant statistical difference in terms of total operation time (95% confidence interval [CI] = 5.67, 6.01 vs. 95% CI = 6.32, 6.66), aortic cross-clamping time (95% CI = 75.92, 90.00 vs. 95% CI = 111.19, 126.65), and total cardiopulmonary bypass time (95% CI = 115.9, 134.75 vs. 95% CI = 174.52, 201.27) between the international missions and local surgical team, respectively. The mortality rate was higher in patients operated on by the local team (13.7%) than by international missions (8.8%), however there was no statistical difference.

CONCLUSION

This study has shown the beneficial advantage of international surgical missions to newly established open-heart centers with advanced facilities and skill-deprived team. International surgical missions have greatly contributed to the progression of the center as they oversee and support the programs.

摘要

目的

评估在国际医疗队多次来访后,当地团队在冠状动脉搭桥手术的实施数量及总体患者治疗结果方面所掌握技能的效率。

方法

这是一项回顾性研究,纳入了2016年5月至2023年12月期间在该中心被诊断为慢性冠状动脉疾病后接受手术的所有患者。从患者病历以及手术记录文件中获取患者的人口统计学数据,录入结构化问卷,然后输入统计程序。

结果

该中心共有290例患者接受了冠状动脉搭桥手术。国际医疗队共实施了159例(54.8%)手术,而当地团队共为131例(45.2%)患者进行了手术。研究显示,国际医疗队和当地手术团队在总手术时间(95%置信区间[CI]=5.67,6.01对95%CI=6.32,6.66)、主动脉阻断时间(95%CI=75.92,90.00对95%CI=111.19,126.65)以及总体外循环时间(95%CI=115.9,134.75对95%CI=174.52,201.27)方面分别存在显著统计学差异。当地团队手术患者的死亡率(13.7%)高于国际医疗队手术患者(8.8%),但无统计学差异。

结论

本研究显示了国际外科医疗队对设施先进但缺乏技术的新建心脏中心的有益优势。国际外科医疗队通过监督和支持项目,为该中心的发展做出了巨大贡献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdb4/12053801/5c56db0087fd/bjcvs-40-03-e20240075-g01.jpg

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