Surgical Task Shifting Helps Reduce Neonatal Mortality in Ethiopia: A Retrospective Cohort Study.

Surgery Research and Practice Pub Date : 2019-02-03 eCollection Date: 2019-01-01 DOI:10.1155/2019/5367068

Yihun Tariku, Tadele Gerum, Mareshet Mekonen, Haddis Takele

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引用次数: 5

Abstract

Background: To improve access to surgical service and to reduce neonatal mortality Ethiopia implemented surgical task shifting to nonphysician surgeons (NPSs). We aim at assessing surgical outcomes between NPSs and physician surgeons working in two hospitals.

Methods: We collected data from two hospitals on 474 maternal medical records. Completed maternal medical records were included in this study. Data were entered into Epi Info version 7 and analyzed by SPSS version 20 software. Both descriptive and inferential statistics were done. If the 95% confidence interval values exclude the null value, the factor was considered as a significant factor.

Result: Totally, 3429 mothers delivered in two hospitals. Of them, 840 (24.5%) delivered by caesarian section (CS), but 474 mothers' records meet the inclusion criteria included in this study. Of 474 CS deliveries, the majority (82%) of them were performed by NPS. Maternal or fetal emergency conditions were the main reasons (92.0%, n=436) for CS. Task shifting does not affect immediate newborn outcomes (ARR, 1.24 (0.55, 2.78)), but duration of hospitalization (ARR: 4 (2.3, 7.5)), condition of the fetus during admission (ARR: 5.22 (2.9, 9.2)), and type of anesthesia used (ARR: 0.2 (0.1, 0.4)) significantly determine the outcome.

Conclusion: Surgical task shifting to NPS does not affect the immediate newborn outcome. But general anesthesia is one of the major factors that affects the outcome.

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手术任务转移有助于降低埃塞俄比亚新生儿死亡率:一项回顾性队列研究。

背景:为了提高外科服务的可及性和降低新生儿死亡率，埃塞俄比亚实施了外科任务转移到非内科外科医生(nps)。我们的目的是评估nps和在两家医院工作的外科医师之间的手术结果。方法:收集两所医院474份产妇病历资料。本研究纳入了完整的产妇医疗记录。数据录入Epi Info version 7，采用SPSS version 20软件进行分析。描述性统计和推断性统计都进行了研究。如果95%置信区间值排除了空值，则认为该因素是显著因素。结果:两家医院共分娩3429例。其中840例(24.5%)为剖腹产分娩，但474例产妇的记录符合本研究的纳入标准。在474例CS分娩中，大多数(82%)由NPS执行。母体或胎儿的紧急情况是发生CS的主要原因(92.0%，n=436)。任务转移不影响新生儿的直接结局(ARR, 1.24(0.55, 2.78))，但住院时间(ARR: 4(2.3, 7.5))、入院时胎儿的状况(ARR: 5.22(2.9, 9.2))和使用的麻醉类型(ARR: 0.2(0.1, 0.4))显著决定了结局。结论:手术任务转移到NPS不影响新生儿的直接预后。但全身麻醉是影响结果的主要因素之一。

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Surgery Research and Practice

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期刊介绍： Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.