Age at Primary Cleft Lip Repair: A Potential Bellwether Indicator for Pediatric Surgery
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Citações na Scopus
5
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
VANDERBURG, Richard
DESAI, Priya
DONKOR, Peter
MOSSEY, Peter
STIEBER, Erin
V, Felicity Mehendale
Citação
PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, v.9, n.6, article ID e3657, 5p, 2021
Resumo
Background: The bellwether procedures described by the Lancet Commission on Global Surgery represent the ability to deliver adult surgical services after there is a clear and easily made diagnosis. There is a need for pediatric surgery bellwether indicators. A pediatric bellwether indicator would ideally be a routinely performed procedure, for a relatively common condition that, in itself, is rarely lethal at birth, but that should ideally be treated with surgery by a standard age. Additionally, the condition should be easy to diagnose, to minimize the confounding effects of delays or failures in diagnosis. In this study, we propose the age at primary deft lip (CL) repair as a bellwether indicator for pediatric surgery. Method: We reviewed the surgical records of 71,346 primary deft surgery patients and ultimately studied age at CL repair in 40,179 patients from 73 countries, treated by Smile Train partners for 2019. Data from Smile Train's database were correlated with World Bank and WHO indicators. Results: Countries with a higher average age at CL repair (delayed access to surgery) had higher maternal, infant, and child mortality rates as well as a greater risk of catastrophic health expenditure for surgery. There was also a negative correlation between delayed CL repair and specialist surgical workforce numbers, life expectancy, percentage of deliveries by C-section, total health expenditure per capita, and Lancet Commission on Global Surgery procedure rates. Conclusion: These findings suggest that age at CL repair has potential to serve as a bellwether indicator for pediatric surgical capacity in Lower- and Middle-income Countries.
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