Magnitude of Emergency Surgical Interventions Delay for Acute Abdomen and its Associated Patient and Hospital-Related Factors in Tikur Anbessa Specialized Hospital
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Date
2024-01-11
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Addis Ababa University
Abstract
Background: Acute abdomen surgeries require immediate attention and treatment. Delay of emergency surgical interventions results in increased mortality rates and healthcare costs, prolonged hospital stays, and poor patient outcomes. Understanding the magnitude and related factors of this delay in management can help in improving patients’ outcomes, shorten the length of stay, and minimize the burden in emergency rooms.
Objectives: To identify the magnitude, and assess the associated patient and hospital-related factors for the delay of emergency surgery for acute abdomen in the TASH emergency department.
Methods: Single-center, prospective, cross-sectional study done among acute abdomen cases in the TASH emergency department with a total of 97 patients selected from September 1- December 4, 2023. Data was gathered through chart review and operation room documentation logbook utilizing a standardized questionnaire adapted from prior research with few modifications. The data was coded, cleaned, and loaded into the SPSS version 26 software program for further analysis. Descriptive statistics, and bivariate, and multivariate analysis were performed to evaluate the outcome and associated factors. The odd ratio was employed to estimate relative risk and P values < 0.05 were considered significant.
Results: The overall prevalence and magnitude of the delay in emergency surgical intervention for acute abdomen were 40.2%. The age group 35-45 had the highest frequency of delay, with an AOR of 27.067 (95% CI = 2.516-291.187, P=0.007). This study data also demonstrated that a prolonged duration of stay in an emergency (> 24 hours) is substantially associated with delays in surgical care, compared to less than 24 hours stays (AOR=4.551 (95% CI=1.355-15.283, P=0.014).
Conclusion: Acute abdomen is a surgical emergency that most commonly affects men and young adults. Patients aged 35-45 and who spent more than 24 hours in the emergency department were more likely to be delayed. This study indicated a considerable incidence of 40.2% delayed emergency surgical management for acute abdomen, above prior studies. Emergency surgical care at our hospital is frequently delayed due to a shortage of physical resources, delays in decision-making to operate, and the surgical team's preoccupation with other emergency cases
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MAGNITUDE OF EMERGENCY SURGICAL INTERVENTIONS DELAY