Scientific Review
Perioperative Risk Assessment in Humanitarian Settings: A Scoping Review
Hannah Wild,
Barclay T. Stewart,
Christopher LeBoa,
Teresa Jewell,
Kajal Mehta,
Sherry M. Wren,
Corresponding Author
Hannah Wild
Department of Surgery, University of Washington, 1959 NE Pacific St., 98195 Seattle, WA, USA
[email protected]Search for more papers by this authorBarclay T. Stewart
Department of Surgery, University of Washington, 1959 NE Pacific St., 98195 Seattle, WA, USA
Global Injury Control Section, Harborview Injury Prevention and Research Center, Seattle, WA, USA
Search for more papers by this authorChristopher LeBoa
Department of Environmental Health Sciences, University of California Berkeley, Berkeley, CA, USA
Search for more papers by this authorTeresa Jewell
Health Science Library, University of Washington, Seattle, WA, USA
Search for more papers by this authorKajal Mehta
Department of Surgery, University of Washington, 1959 NE Pacific St., 98195 Seattle, WA, USA
Search for more papers by this authorSherry M. Wren
Stanford University School of Medicine, Stanford, CA, USA
Search for more papers by this authorHannah Wild,
Barclay T. Stewart,
Christopher LeBoa,
Teresa Jewell,
Kajal Mehta,
Sherry M. Wren,
Corresponding Author
Hannah Wild
Department of Surgery, University of Washington, 1959 NE Pacific St., 98195 Seattle, WA, USA
[email protected]Search for more papers by this authorBarclay T. Stewart
Department of Surgery, University of Washington, 1959 NE Pacific St., 98195 Seattle, WA, USA
Global Injury Control Section, Harborview Injury Prevention and Research Center, Seattle, WA, USA
Search for more papers by this authorChristopher LeBoa
Department of Environmental Health Sciences, University of California Berkeley, Berkeley, CA, USA
Search for more papers by this authorTeresa Jewell
Health Science Library, University of Washington, Seattle, WA, USA
Search for more papers by this authorKajal Mehta
Department of Surgery, University of Washington, 1959 NE Pacific St., 98195 Seattle, WA, USA
Search for more papers by this authorSherry M. Wren
Stanford University School of Medicine, Stanford, CA, USA
Search for more papers by this authorSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00268-023-06893-x.
Copyright comment: Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
Abstract
Background
No validated perioperative risk assessment models currently exist for use in humanitarian settings. To inform the development of a perioperative mortality risk assessment model applicable to humanitarian settings, we conducted a scoping review of the literature to identify reports that described perioperative risk assessment in surgical care in humanitarian settings and LMICs.
Methods
We conducted a scoping review of the literature to identify records that described perioperative risk assessment in low-resource or humanitarian settings. Searches were conducted in databases including: PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, World Health Organization Catalog, and Google Scholar.
Results
Our search identified 1582 records. After title/abstract and full text screening, 50 reports remained eligible for analysis in quantitative and qualitative synthesis. These reports presented data from over 37 countries from public, NGO, and military facilities. Data reporting was highly inconsistent: fewer than half of reports presented the indication for surgery; less than 25% of reports presented data on injury severity or prehospital data. Most elements of perioperative risk models designed for high-resource settings (e.g., vital signs, laboratory data, and medical comorbidities) were unavailable.
Conclusion
At present, no perioperative mortality risk assessment model exists for use in humanitarian settings. Limitations in consistency and quality of data reporting are a primary barrier, however, can be addressed through data-driven identification of several key variables encompassed by a minimum dataset. The development of such a score is a critical step toward improving the quality of care provided to populations affected by conflict and protracted humanitarian crises.
Supporting Information
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| wjsbf01907-sup-0001.docxapplication/docx, 19.5 KB | Supplementary file1 (DOCX 20 KB) |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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