Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review

Fitsum Kifle, Tewodros Kifleyohanes, Jolene Moore, Ayele Teshome, Bruce M. Biccard

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Perioperative registries can be utilised to track outcomes, develop risk prediction models, and make evidence-based decisions and interventions. To better understand and support initiatives to establish clinical registries, this study aimed to assess the indications, challenges, and characteristics of successful perioperative registries in low-resource settings, where there is unmet surgical demand and patients have a mortality rate up to double that of high-income countries. We conducted a librarian-assisted literature search of international research databases of articles published between January 1969 and January 2021. Studies were filtered using predefined criteria and responses to two Mixed Method Appraisal Tool screening questions. A Direct Content Analysis Method was used to synthesis. e data for eligible studies based on predefined criteria. The search identified 2793 abstracts. After removing duplicates and excluding studies that did not meet eligibility criteria, twelve studies were included, conducted in South America (n = 4), Africa (n = 5), the Middle East (n = 2), and Asia (n = 1). The lack of context-specific data for determining and evaluating patient outcomes (n = 7) was the major indication for implementation. Organising local research teams and engaging stakeholders in the host country were associated with successful implementation. Inadequate funding for data collectors and monitoring data quality were identified as challenges (n = 4). The goal of a perioperative registry is to generate data to influence and support quality improvement, and national surgical policies. Efforts to establish perioperative registries in low- and middle-income countries should engage local teams and stakeholders and seek to overcome challenges in data collection and monitoring.
Original languageEnglish
JournalWorld Journal of Surgery
Publication statusPublished - 19 Jan 2023

Bibliographical note

The authors would like to thank Ms. Dilshaad Brey for her assistance during the database searches and in organising the search results. UCT Division of Global Surgery and Prof Maswime’s SA MRC Mid-career Scientist Award for partially funding this study.

Open access funding provided by University of Cape Town. This study was partially funded by the University of Cape Town Department of Global Surgery, and the Network for Perioperative and Critical Care (N4PCc).


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