Management Outcome and Associated Factors of Surgically Treated Non Traumatic Acute Abdomen at Attat Hospital, Gurage Zone, Ethiopia

Abstract

Background: Non traumatic acute abdomen is an acute onset of abdominal disease entities that require immediate surgical intervention in most of the cases. The causes of non-traumatic surgical acute abdomen and their relative incidence vary in different populations. Objective: The aim of this study was to assess the management outcome and associated factors of surgically treated non-traumatic acute abdomen. Methods: Hospital-based prospective cross sectional study was conducted on surgically treated non-traumatic acute abdomen cases admitted at Attat catholic hospital surgical ward starting from January 2017 to September 2018. Data was collected using history, physical examination, patients’ card and operation registration book as necessary. The collected data were checked for incorrectness and inconsistencies and SPSS version 21 used for the descriptive, binary and multivariate logistic regression analysis of the data. On binary logistic regression analysis a p-value < 0.25 was used as a candidate for multivariate logistic regression analysis. Statistical significant association was tested at a p-value of < 0.05. Results: There were 192 non-traumatic emergency surgical acute abdomens admitted in surgical ward and 171 (89%) of cases were managed surgically while 11% were managed conservatively. The three top causes of acute surgical abdomen were acute appendicitis accounting 48% followed by bowel obstruction 28% and Peritonitis 24%. Late presentation of patients before intervention, sex, age and postoperative complications were independent predictors with management outcome in our study. The total postoperative complication rate was 17% of which the commonest early postoperative complications were wound infection (5.4%), sepsis (4.3%) and pneumonia (2.3%). About 90.1% were discharged well while 9.35% were passed away in the hospital which is unacceptably high mortality. Conclusion and recommendation: The overall mortality was more in cases from rural area due to delay at presentation, on higher extreme age patients, those who developed peritonitis and postoperative complications. To decrease this problem, creation of health awareness on acute abdomen to the general population and to the low and mid-level health care providers for early referral, pre and postoperative management to decrease postoperative complications and death has great importance.