Gazzetta Joshua D, Mutambo Poster P, Mpabalwani Mutimba B, Mulenga Mwamba Jc, Phiri Cyrus, Shaba Kelvin, Makasa Emmanuel M
Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.
Centre for Surgical Healthcare Research (CSHR).
Med Res Arch. 2025 Jun;13(6). doi: 10.18103/mra.v13i6.6574. Epub 2025 Jun 30.
In low and middle-income countries, nine out of every ten persons is unable to access safe and timely surgery. The limited perioperative data in resource-limited settings compromises surgical and research capacity growth. By increasing data availability, surgical disparities may be addressed through research efforts and quality initiatives. This project aimed to implement and evaluate a perioperative registry in a tertiary care hospital in a low-income country.
A prospective emergency laparotomy perioperative registry was implemented in Zambia's largest teaching and referral hospital. Over the first 6-months of implementation, 162 patients were included. Data was collected postoperatively, before discharge, and at 30 days. The registries feasibility was assessed by evaluating patient accrual, retention, and 30-day completion rates. The registries fidelity was measured by evaluating data missingness. A participant acceptance survey was retrospectively collected and analyzed for the first 25 consecutively enrolled patients.
The capture rate of the registry could not be calculated due to a destroyed theatre logbook. The participant accrual and retention rates were 99.4% and 95.1%, respectively. The participant completion rate at 30-days was 75.6%. The overall incidence of missing information in the registry was 3.5%. More than 75% of participant responses to the acceptance survey were positive in each category regarding the ethical conduct of research and the storing of personal data.
The value of this study is the reporting and evaluation of a successful perioperative registry implementation with minimal external funding. This framework is being used to develop new data registries and may provide a roadmap for other hospitals with resource constraints.
在低收入和中等收入国家，每十人中就有九人无法获得安全及时的手术治疗。资源有限环境下围手术期数据有限，不利于手术和研究能力的发展。通过增加数据可用性，可通过研究努力和质量改进措施来解决手术差距问题。本项目旨在在一个低收入国家的三级医院实施并评估一个围手术期登记系统。
在赞比亚最大的教学和转诊医院实施了一项前瞻性急诊剖腹手术围手术期登记系统。在实施的前6个月，纳入了162例患者。术后、出院前和30天时收集数据。通过评估患者入组率、留存率和30天完成率来评估登记系统的可行性。通过评估数据缺失情况来衡量登记系统的保真度。对连续入组的前25例患者进行回顾性收集并分析参与者接受度调查。
由于手术室日志被毁，无法计算登记系统的捕获率。参与者入组率和留存率分别为99.4%和95.1%。30天时参与者完成率为75.6%。登记系统中信息缺失的总体发生率为3.5%。在研究的道德行为和个人数据存储的每个类别中，超过75%的参与者对接受度调查的回答是积极的。
本研究的价值在于报告和评估在极少外部资金支持下成功实施的围手术期登记系统。该框架正用于开发新的数据登记系统，并可能为其他资源有限的医院提供路线图。
