Trial reportBMC surgery2025
Return to normal activity after abdominal surgery: a pre-planned secondary analysis of a randomised controlled trial across seven low- and middle-income countries.
Trial report in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecovery after major surgery is a key priority identified by patients, communities and policymakers in low- and middle-income countries (LMICs), with important societal and financial implications. With global burden of surgical diseases rising, little is known about how well patients return to normal activities after surgery in these settings. This study aimed to describe patterns of return to normal activity after major abdominal surgery and identify associated factors in LMICs.
methodsThis was a pre-planned analysis of a cluster-randomised randomised trial testing routine sterile glove and instrument change at the time of abdominal wound closure to prevent surgical site infection in seven LMICs (India, Mexico, Rwanda, Benin, South Africa, Nigeria, Ghana). 961 patients were excluded because of incomplete missing primary outcome. The primary outcome measure was a patients self-reported full return to their normal activities at 30 days after surgery. Factors associated with return to normal activities within 30-days of surgery was explored using a Bayesian mixed-effects logistic regression model. Sensitivity analyses were performed accounting for missing data.
results12,340 patients across 81 centres were included. Overall, 65.3% (8064/12340) patients had returned to normal activity by 30-days after surgery. Patients undergoing surgery for benign than cancer surgery (67.0% vs. 59.7%), minor compared to major surgery (71.0% vs. 63.5%), and non-midline compared to midline (74.9% vs. 58.7%) had higher rates of return to normal activities within 30-days from abdominal surgery. In an adjusted model, factors associated with return to normal activities are benign surgery (OR: 0.61, 95% CI: 0.53-0.71), minor surgery (OR: 0.56, 95% CI: 0.49-0.64), and non-midline operations (OR: 1.57, 95% CI: 1.41-1.75). When accounting for missing data, consistent findings were observed.
conclusionsWith rising need for surgical care and non-communicable disease globally, this study highlights the groups of patients at critical need for improving return to normal activity or recovery after surgery in LMICs. Improving access and implementation of rehabilitation pathways, aligned to the World Health Organisation, may be crucial to improve financial risk protection to patient and reduce productivity loss to the economy.
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