One in five patients who undergo surgery in Africa will develop postoperative complications. Two percent will die following surgery -- a mortality rate that is twice the global average of one percent, despite being on average younger and healthier than most people who succumb after surgery in the developed world.
This is according to a study issued by the University of Cape Town (UCT), recently published in The Lancet medical journal.
The African Surgical Outcomes Study (ASOS) surveyed the cases of 11,422 patients from 247 hospitals in 25 African countries -- including Ethiopia, Egypt, Nigeria and Zambia. It was conducted in 2016 over a specific week for each hospital by an international team of researchers.
"Data from Africa has been limited until this point," says Groote Schuur Hospital professor Bruce Biccard, the study's lead author, from UCT's department of anaesthesia and perioperative medicine.
The study found that nearly 95 percent of all surgical deaths analysed occurred the day after surgery. Resources appeared to be a significant contributor to postoperative mortality in the continent -- with scanty workforce, a limited number of hospital beds and poor systems to check up on patients after surgery possibly playing a role.
"Although increased access to surgery is important, it is essential that surgery is safe. The majority of deaths in the ASOS study occurred in the postoperative period. It suggests that interventions to identify patients at risk in the postoperative period may make surgery safer in Africa," adds Biccard.
The study also revealed that surgeries in the continent were low, and fewer than 43 percent were elective –– with a great number of patients undergoing emergency operations.
Biccard believes this highlights another challenge -- that many people who need surgery might not have access to it.
Through this study, the researchers hope the data provided will inform safer surgery in Africa. "The publication of the ASOS study provides important data necessary to understand the challenges to improving surgical outcomes on the continent," says Biccard.
A continent-wide quality improvement programme –- addressing the problem of limited surgical resources and increasing postoperative surveillance of surgical patients –– may lead to better surgical outcomes in Africa, the researchers suggest.