Jin, James and Akau'ola, Salesi' and Yip, Cheng-Har and Nthumba, Peter and Ameh, Emmanuel A. and de Jonge, Stijn and Mehes, Mira and Waiqanabete, Iferemi and Henry, Jaymie and Hill, Andrew (2021) Effectiveness of quality improvement processes, interventions, and structure in trauma systems in low- and middle-income countries: A systematic review and meta-analysis. World Journal of Surgery, 45 (7). pp. 1982-1998. ISSN 0364-2313, DOI https://doi.org/10.1007/s00268-021-06065-9.
Full text not available from this repository.Abstract
Background Trauma mortality in low- and middle-income countries (LMICs) remains high compared to high-income countries. Quality improvement processes, interventions, and structure are essential in the effort to decrease trauma mortality. Methods A systematic review and meta-analysis of interventional studies assessing quality improvement processes, interventions, and structure in developing country trauma systems was conducted from November 1989 to August 2020 according to the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were conducted in an LMIC population according to World Bank Income Classification, occurred in a trauma setting, and measured the effect of implementation and its impact. The primary outcome was trauma mortality. Results Of 37,575 search results, 30 studies were included from 15 LMICs covering five WHO regions in a qualitative synthesis. Twenty-seven articles were included in a meta-analysis. Implementing a pre-hospital trauma system reduced overall trauma mortality by 45% (risk ratio (RR) 0.55, 95% CI 0.4 to 0.75). Training first responders resulted in an overall decrease in mortality (RR 0.47, 95% CI 0.28 to 0.78). In-hospital trauma training with certified courses resulted in a reduction of mortality (RR 0.71, 95% CI 0.62 to 0.78). Trauma audits and trauma protocols resulted in varying improvements in trauma mortality. Conclusion There is evidence that quality improvement processes, interventions, and structure can improve mortality in the trauma systems in LMICs.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Trauma mortality; Low and Middle Income Country; World Bank Income Classification |
| Subjects: | R Medicine > RD Surgery |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 09 Jun 2022 06:36 |
| Last Modified: | 09 Jun 2022 06:36 |
| URI: | http://eprints.um.edu.my/id/eprint/34356 |
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