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08 January 2018

You are more likely to die from surgery if you live here

Africans' risk of dying from scheduled surgery is more than double the global average – one of the continent's biggest healthcare problems.

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The risk of dying from scheduled surgery in Africa is more than double the global average, researchers said in a study shedding light on one of the continent's biggest, but poorly investigated, healthcare problems.

Patients who go under the knife in Africa in theory have a lower profile for risk than counterparts elsewhere, as they tend to be younger and are likelier to be admitted for minor rather than major surgery, the investigators found.

Probe into surgery

But, they discovered, nearly one in five people who underwent surgery in Africa developed complications.

In the case of elective surgery – operations that are scheduled in advance and do not involve a medical emergency – the death rate was 1.0%, compared with 0.5% in the global average.

A previous Health24 article highlights some interesting facts about surgery worldwide.

The paper, published in The Lancet medical journal, is described as the deepest and widest probe into surgery across Africa.

It brought together more than 30 researchers who trawled through data from 247 hospitals in 25 countries.

Young and physically strong

The main goal was to cover the outcome on 10 885 in-patient surgical procedures, a third of which was for a Caesarean section.

But the data net also included details about any complications, the number of beds, operating rooms and surgical staff, providing vital but fine-grained information about hospital infrastructure.

More than four in every five patients could be considered low-risk candidates for surgery, as they were physically strong and were young, with an average age of 38.5 years.

But complications, mostly entailing an infection, occurred in 18.2% of all patients. Nearly one in 10 (9.5%) of patients with complications died.

Post-operative risk

Lead researcher Bruce Biccard, a professor at the Groote Schuur Hospital in Cape Town, South Africa, pointed the finger at the post-operative phase, where 95% of surgery deaths occurred.

Many of these fatalities could have been prevented, he said.

"Many lives could be saved by effective monitoring of patients who have developed complications and increasing the resources necessary to achieve this objective," Biccard said.

"Surgical outcomes will remain poor in Africa until the problem of under-resourcing is addressed."

The study included Algeria, Libya and Egypt in its scope, but did not include some of Africa's poorest countries, such as Burkina Faso, Liberia and Sudan, or war-torn Somalia. Smaller remote hospitals, too, generally lay outside the data haul.

Image credit: iStock

 
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