Determinants of Access to Emergency Surgery at the University College Hospital, Ibadan

NCT04487496 | Completed DMC

• 1 other identifier: U1111-1254-0480
• Study Type: observational
• Target: 87
• Locations: 1 country
• Sites: 1

Brief Summary

Access to surgery is reported to be significantly lower in low income countries like Nigeria, and upwards of 5 billion people globally lack safe access to surgery. The investigators intend to answer the question, what is the burden of access to acute care surgery alongside their determinants in the University College Hospital, Ibadan (UCH). The expected results from this study will provide basis for evidence-based policy aimed at improving time-to-emergency surgery and thus improve outcomes. A cross-sectional doctors' survey and a prospective case records review would be the study designs; using a minimum of fifty-one participants and case records respectively. The doctors will be selected randomly from all the surgical services and the emergency department in the UCH, ensuring a fairly equal allocation. The case notes will be of patients in the UCH requiring emergency surgery that had surgeries. Data from this study will be entered and analysed using STATA/MP 15.0 (Stata Corp, College station, TX).

Conditions

Access to Emergency Surgery

Keywords

Emergency surgery; Access to emergency surgery; Acute surgical care; Acute trauma care

Outcome Measures

Primary Outcomes (2)

• Time-to-surgery

  This will collect information about the time from specific event (onset of symptoms, entry into the hospital, diagnosis and decision for surgical care) to the actual onset of the emergency surgery

  One year

• Factors affecting onset of emergency surgery

  This will gather from the doctors' survey and the prospective case records review, the patient related, healthcare giver related and institutional related determinants of access to emergency surgery

  One year

Secondary Outcomes (1)

• Post-operative outcome

  One year

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

This shall comprise all the healthcare givers related to the surgical specialties in UCH, these include the following departments: surgery, plastics and reconstructive and aesthetic surgery, neurological surgery, orthopaedics and trauma, otorhinolaryngology, ophthalmology, obstetrics and gynaecology, oral and maxillofacial surgery, anaesthesia as well as the accident and emergency. The case-records of all patients presenting through the emergency room of University College Hospital Ibadan, requiring emergency surgery as determined by the surgical services.

You may qualify if:

• All recruited doctors who give consent
• All eligible case records of surgical emergencies determined by the surgical services.

You may not qualify if:

• Case records of patients to be directly managed by the principal investigator
• Case records of patients who die before surgery

Sponsors & Collaborators

• University College Hospital, Ibadan: lead

Study Sites (1)

University College Hospital

Ibadan, Oyo State, 5116, Nigeria

Location

Related Publications (8)

• Carr BG, Bowman AJ, Wolff CS, Mullen MT, Holena DN, Branas CC, Wiebe DJ. Disparities in access to trauma care in the United States: A population-based analysis. Injury. 2017 Feb;48(2):332-338. doi: 10.1016/j.injury.2017.01.008. Epub 2017 Jan 3.

  PMID: 28069138 BACKGROUND

• Chawla KS, Rutkow L, Garber K, Kushner AL, Stewart BT. Beyond a Moral Obligation: A Legal Framework for Emergency and Essential Surgical Care and Anesthesia. World J Surg. 2017 May;41(5):1208-1217. doi: 10.1007/s00268-016-3866-6.

  PMID: 28180984 BACKGROUND

• Gani F, Sakran JV, Canner JK. Emergency Department Visits For Firearm-Related Injuries In The United States, 2006-14. Health Aff (Millwood). 2017 Oct 1;36(10):1729-1738. doi: 10.1377/hlthaff.2017.0625.

  PMID: 28971917 BACKGROUND

• MC, R. (1991). An in-vivo of the microbial proliferation beneath transport film dressings in: Maki DG, ed, International congress and symposium series No 179, improving catheter site care. London Series (pp. 29-33). London: Royal Society of Medicine.

  BACKGROUND

• Scott JW, Havens JM, Wolf LL, Zogg CK, Rose JA, Salim A, Haider AH. Insurance status is associated with complex presentation among emergency general surgery patients. Surgery. 2017 Feb;161(2):320-328. doi: 10.1016/j.surg.2016.08.038. Epub 2016 Oct 4.

  PMID: 27712875 BACKGROUND

• Solomon, L., Warwick, D., & Nayagam, S. (2010). Apley's System of Orthopaedics and Fractures. London: Hodder Arnold.

  BACKGROUND

• Watters DA, Guest GD, Tangi V, Shrime MG, Meara JG. Global Surgery System Strengthening: It Is All About the Right Metrics. Anesth Analg. 2018 Apr;126(4):1329-1339. doi: 10.1213/ANE.0000000000002771.

  PMID: 29547428 BACKGROUND

• World health statistics 2019: monitoring health for the SDGs, sustainable development goals. Licence: CC BY-NC-SA 3.0 IGO. (2019). Geneva: World Health Organization. Retrieved August 15, 2019, from https://www.who.int/gho/publications/world_health_statistics/2019/EN_WHS_2019_Main.pdf?ua=1

  BACKGROUND

Study Officials

• Promise T Jaja, MB;BS, MSc

  University College Hospital, Ibadan

  PRINCIPAL INVESTIGATOR

• Adefemi O Afolabi, MB;BS, FWACS

  University College Hospital, Ibadan

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Doctor

Study Record Dates

• First Submitted: June 22, 2020
• First Posted: July 27, 2020
• Study Start: August 17, 2020
• Primary Completion: June 30, 2022
• Study Completion: September 30, 2022
• Last Updated: May 12, 2023

Record last verified: 2023-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR
• Time Frame: The data will be available within two years of the final completion of the study
• Access Criteria: Access will be granted following a review of written requests for the data

Locations

NG (1)