喀麦隆西北部一家转诊医院腹部外科急诊的频谱、管理和结果

Ngwa Ebogo Tagang Titus, Ntih Mariette Liekeh, Ngock Farra Fola George, Sama Akayun, Sena Guylaine Rosine, Nzinga Joy Richie, Nchufor Roland Ndouh, Pisoh Tangnyin Christopher
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引用次数: 0

摘要

目的:腹部外科急诊是低收入和中等收入国家的一个主要健康负担,在这些国家,管理往往非常具有挑战性,并与高发病率和死亡率相关。腹部外科急诊的范围、处理和结果需要更新。方法:这是一项在喀麦隆巴门达进行的为期2年的以医院为基础的回顾性横断面研究。我们回顾了符合纳入标准的患者记录,收集和分析了术前、术中和术后的数据。结果:回顾性分析共纳入207例患者,男女比例为1.4:1。平均年龄47.4(±19.4)岁。肠梗阻(34.8%)和消化性溃疡穿孔(15.5%)是最常见的腹部外科急诊。到就诊和住院延迟的中位延迟和四分位数间隔分别为6(4)天和8(12)小时。术后平均住院时间为11天。48.3%的患者出现并发症;34.78%为重症,17.9%为非计划再手术,15例(7.2%)出院后再入院。住院30天死亡率为19.8%。死亡率与美国麻醉医师协会(ASA)评分较高独立相关;ASA评分bbbb3,年龄b> 60岁,从其他卫生机构转诊。结论:腹膜内肿瘤引起的肠梗阻是喀麦隆西北部腹部外科急诊最常见的原因。在60岁以上ASA评分为> - 3的男性中,腹部急症与非常高的发病率和死亡率相关,并伴有一种以上的合并症。
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Spectrum, Management, and Outcomes of Abdominal Surgical Emergencies at a Referral Hospital in North West Cameroon
Purpose: Abdominal surgical emergencies are a major health burden in low- and middle-income countries where management is often very challenging, and associated with high morbidity and mortality. The spectrum, management, and outcomes of abdominal surgical emergencies needs to be updated.Methods: This was a hospital-based retrospective cross-sectional study carried out in Bamenda, Cameroon over a 2-year period. Records of patients who met the inclusion criteria were reviewed, with pre-, intra- and postoperative data collected and analyzed.Results: There were 207 patients included in this retrospective review (male to female ratio of 1.4:1. The mean age was 47.4 (± 19.4) years. Intestinal obstruction (34.8%) and perforated peptic ulcers (15.5%) were the most common abdominal surgical emergencies. The median delay and interquartile range to presentation and in-hospital delay were 6 (4) days and 8 (12) hours, respectively. The mean length of hospital stay post-surgery was 11days. There were 48.3% of patients who developed a complication; 34.78% were major, 17.9% had an unplanned reoperation, and 15 (7.2%) were readmitted after discharge. The 30-day in hospital mortality was 19.8%. Mortality was independently associated with a high American Society of Anesthesiologists (ASA) score; ASA score > 3, age > 60 years, and referral from other health facilities.Conclusion: Intestinal obstructions from intraperitoneal neoplasm is the most common cause of abdominal surgical emergency in North West Cameroon. Abdominal emergencies here are associated with a very high morbidity and mortality in males > 60 years with an ASA score > 3 and with more than one comorbidity.
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