低收入和中低收入国家的复杂性尾炎:系统性审查和元分析
Renato Pitesa1, Claudia Paterson1, Melanie Flaherty1
1Department of Surgery, The University of Auckland, Auckland, New Zealand.
ANZ journal of surgery
|April 26, 2025
概括
复杂性尾炎在低收入国家 (LICs) 比中低收入国家 (LoMICs) 更普遍,导致患病率和死亡率更高. 有针对性的干预措施对于改善这些地区的手术护理准入和结果至关重要.
科学领域:
- 全球手术全球手术
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 急性尾炎在全球范围内存在显著的健康差异,特别是在高收入国家 (HIC) 和低收入和中等收入国家 (LMIC) 之间.
- 由于医疗保健基础设施和资源有限,复杂尾炎对LMICs产生了不成比例的影响.
- 关于尾炎结果的现有证据主要来自HICs,为LMICs留下了关键的知识差距.
研究的目的:
- 系统地审查和比较低收入国家 (LICs) 和中低收入国家 (LoMICs) 之间的复杂尾炎的流行率.
- 确定LIC和LoMIC之间尾炎结果的差异,包括发病率和死亡率.
主要方法:
- 根据PRISMA指南进行了系统审查,搜索了PubMed,MEDLINE,Embase,Scopus,Google Scholar和Cochrane图书馆.
- 包括的研究包括1990年至2024年间发表的观察性研究和随机对照试验.
- 关注的主要结局是复杂尾炎的发生率.
主要成果:
- 对涉及25582名参与者的87篇文章的分析显示,与LoMICs (23%) 相比,LICs (34%) 的复杂尾炎的综合比例显著更高.
- 在LICs (19%) 和LoMICs (13%) 中,术后发病率也较高.
- 与尾炎相关的死亡率在LIC中明显高 (OR 2.36).
结论:
- 尾炎对LIC和LoMIC的健康构成重大负担,其特点是患病率和死亡率增加.
- 这些发现强调了手术接入和在这些环境中提供护理的严重缺陷.
- 迫切需要有针对性的干预措施,以加强外科护理,改善LIC和LoMIC患者的治疗结果.
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