Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study
Introduction The paucity of data on perioperative outcomes in low- and middle-income countries complicates the design and implementation of targeted interventions to improve the delivery of safe, affordable, accessible and timely surgical and anaesthesia care services. We assessed perioperative outc...
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BMJ Publishing Group
2025-03-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/10/3/e017354.full |
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| author | Fredrick Kateera Robert Riviello Mariella Munyuzangabo Vincent Cubaka Egide Mpanumusingo Alphonse Nshimyiryo Joel M Mubiligi Marcel Nshunguyabahizi Cyprien Shyirambere Grace Umutesi Jocelyn Mizero John Kamau Jean de Dieu Gatete Mark W Newton Bantayehu Sileshi |
| author_facet | Fredrick Kateera Robert Riviello Mariella Munyuzangabo Vincent Cubaka Egide Mpanumusingo Alphonse Nshimyiryo Joel M Mubiligi Marcel Nshunguyabahizi Cyprien Shyirambere Grace Umutesi Jocelyn Mizero John Kamau Jean de Dieu Gatete Mark W Newton Bantayehu Sileshi |
| author_sort | Fredrick Kateera |
| collection | DOAJ |
| description | Introduction The paucity of data on perioperative outcomes in low- and middle-income countries complicates the design and implementation of targeted interventions to improve the delivery of safe, affordable, accessible and timely surgical and anaesthesia care services. We assessed perioperative outcomes of patients undergoing surgical care at three Rwandan rural hospitals—Butaro District Hospital, Kirehe District Hospital and Rwinkwavu District Hospital—supported by Partners In Health/Inshuti Mu Buzima—an international non-governmental organisation.Methods We conducted a 6-month prospective observational cohort study at the three district hospitals. A validated electronic-based perioperative assessment tool was adapted for our setting to capture demographics and clinical information. Descriptive and logistic regression analyses were performed using Stata V.15.1.Results A total of 3289 major surgeries were performed from January to September 2020 at the three hospitals. Overall, 3204 surgeries (97.5%) were performed on women; the median age was 27 years (IQR: 23–33), and emergency cases constituted 86.8% of all cases. Cases with the American Society of Anesthesiologists (ASA) status of 3 or above had higher odds of having surgical or anaesthesia complications compared with cases with ASA status 1 (OR: 11.1, 95% CI: 2.7 to 45.8). Furthermore, emergency cases had 1.8 times higher odds of having a composite outcome (developing complications, surgical site infections or death) compared with elective cases (95% CI: 1.1 to 3.0).Conclusion Our findings highlight the need for improving surgical capacity, reinforcing infection prevention and control measures and leveraging electronic data capture for quality improvement to ensure safer surgery and anaesthesia care in rural Rwanda. |
| format | Article |
| id | doaj-art-bece0a96e91b47dbbcb3cbb7dfba3afc |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Global Health |
| spelling | doaj-art-bece0a96e91b47dbbcb3cbb7dfba3afc2025-08-20T03:39:49ZengBMJ Publishing GroupBMJ Global Health2059-79082025-03-0110310.1136/bmjgh-2024-017354Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort studyFredrick Kateera0Robert Riviello1Mariella Munyuzangabo2Vincent Cubaka3Egide Mpanumusingo4Alphonse Nshimyiryo5Joel M Mubiligi6Marcel Nshunguyabahizi7Cyprien Shyirambere8Grace Umutesi9Jocelyn Mizero10John Kamau11Jean de Dieu Gatete12Mark W Newton13Bantayehu Sileshi14Partners In Health, Kigali, RwandaProgram in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USAPartners In Health/Inshuti Mu Buzima, Rwinkwavu, RwandaDepartment of Research and Training, Partners in Health Rwanda, Kigali, RwandaClinical, Partners In Health/Inshuti Mu Buzima, Kigali, RwandaResearch and Training, Partners In Health/Inshuti Mu Buzima, Kigali, RwandaPartners In Health/Inshuti Mu Buzima, Kigali, RwandaPartners In Health, Kigali, RwandaPartners In Health, Butaro, RwandaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, RwandaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, RwandaAIC Kijabe Hospital, Kijabe, KenyaPartners In Health/Inshuti Mu Buzima, Rwinkwavu, RwandaAIC Kijabe Hospital, Kijabe, KenyaDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USAIntroduction The paucity of data on perioperative outcomes in low- and middle-income countries complicates the design and implementation of targeted interventions to improve the delivery of safe, affordable, accessible and timely surgical and anaesthesia care services. We assessed perioperative outcomes of patients undergoing surgical care at three Rwandan rural hospitals—Butaro District Hospital, Kirehe District Hospital and Rwinkwavu District Hospital—supported by Partners In Health/Inshuti Mu Buzima—an international non-governmental organisation.Methods We conducted a 6-month prospective observational cohort study at the three district hospitals. A validated electronic-based perioperative assessment tool was adapted for our setting to capture demographics and clinical information. Descriptive and logistic regression analyses were performed using Stata V.15.1.Results A total of 3289 major surgeries were performed from January to September 2020 at the three hospitals. Overall, 3204 surgeries (97.5%) were performed on women; the median age was 27 years (IQR: 23–33), and emergency cases constituted 86.8% of all cases. Cases with the American Society of Anesthesiologists (ASA) status of 3 or above had higher odds of having surgical or anaesthesia complications compared with cases with ASA status 1 (OR: 11.1, 95% CI: 2.7 to 45.8). Furthermore, emergency cases had 1.8 times higher odds of having a composite outcome (developing complications, surgical site infections or death) compared with elective cases (95% CI: 1.1 to 3.0).Conclusion Our findings highlight the need for improving surgical capacity, reinforcing infection prevention and control measures and leveraging electronic data capture for quality improvement to ensure safer surgery and anaesthesia care in rural Rwanda.https://gh.bmj.com/content/10/3/e017354.full |
| spellingShingle | Fredrick Kateera Robert Riviello Mariella Munyuzangabo Vincent Cubaka Egide Mpanumusingo Alphonse Nshimyiryo Joel M Mubiligi Marcel Nshunguyabahizi Cyprien Shyirambere Grace Umutesi Jocelyn Mizero John Kamau Jean de Dieu Gatete Mark W Newton Bantayehu Sileshi Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study BMJ Global Health |
| title | Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study |
| title_full | Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study |
| title_fullStr | Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study |
| title_full_unstemmed | Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study |
| title_short | Perioperative outcomes at three rural Rwandan district hospitals: a 28-day prospective observational cohort study |
| title_sort | perioperative outcomes at three rural rwandan district hospitals a 28 day prospective observational cohort study |
| url | https://gh.bmj.com/content/10/3/e017354.full |
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