Emergency general surgery in a public hospital in Malaysia
Journal – The Medical journal of Malaysia
Publication date – Sep – 2020
Authors – Kandasami Palayan, Yita Tang, Chi Xuan Sam, Chern Wayne Kee, Muhammad Naim Rusman, Afifah Aflah Mohd Derus, Mahadevan Deva Tata
Keywords – emergency surgery, General Surgery, Out of hours, outcomes
Open access – Yes
Speciality – Emergency surgery, General surgery
World region Southern Asia
Language – English
Submitted to the One Surgery Index on November 8, 2020 at 6:52 pm
Introduction: Patients undergoing emergency general surgery (EGS) are at risk for death and complications. Information on the burden of EGS is critical for developing strategies to improve the outcomes.
Methods: In this retrospective cohort study, medical records of all general surgical operations in a public hospital were reviewed for the period 1st January 2017 to 31st December 2017. Data on patient demographics, operative workload, case mix, time of surgery and outcomes were analysed.
Results: Of the 2960 general surgical operations that were performed in 2017, 1720 (58.1%) of the procedures were performed as emergencies. The mean age for the patients undergoing emergency general surgical procedures was 37.9 years (Standard Deviation, ±21.0), with male preponderance (57.5%). Appendicitis was the most frequent diagnosis for the emergency procedures (43%) followed by infections of the skin and soft tissues (31.6%). Disorders of the colon and rectum ranked as the third most common condition, accounting for 6.7% of the emergency procedures. Majority of emergency surgery (59.3%) took place after office hours and on weekends. Post-operative deaths and admissions to critical care facilities increased during EGS when compared to elective surgery, p<0.01.
Conclusions: EGS constitutes a major part of the workload of general surgeons and it is associated significant risk for death and post-operative complications. The burden of EGS must be recognised and patient care systems must evolve to make surgery safe and efficient.
OSI Number – 20725
PMID – 32918411