Surgical emergency presentation in a private teaching hospital in Nigeria: a 2- year review

Abstract

Background: Pattern of admissions into the accident and emergency units vary worldwide with most studies showing surgical preponderance. Unlike the outcome of our study that showed more of medical cases, another study done in University College Hospital (UCH), Ibadan, Nigeria showed that 61% of admissions into the accident and emergency unit were surgical with trauma in general constituting 45.1%. With rising population and reduced funding, most tertiary care hospitals in developing countries grapple with high patient admissions into their emergency
units. Lack of adequate personnel and facilities to cater for such patients result in poor patient satisfaction and management. Adequate funding and regular training of personnel should therefore be emphasized if we are to approach the standard care provided in developed countries 4 and reap a satisfactory outcome in care of emergency surgical situations.

Method: This is a 2-year retrospective study, data of all patients admitted in the adult accident and emergence section of Babcock University between January 2016 and December 2017 were retrieved and reviewed. Frequencies were presented as absolute values, charts and percentages.

Results: In 2016, a total of 1901 emergency cases presented to the adult accident and emergency unit of Babcock University Teaching Hospital of which 341 were surgical. In 2017, a total of 1887 emergency cases were seen in the adult accident and emergency unit of Babcock University Teaching Hospital of which 363 [17.24%] were surgical. Overall, a total of 3788 emergency cases presented of which 704 [17.24%] were surgical cases. Of these 704 cases ,457 of them [64.9%] were acute surgical emergencies like head injuries, burns, cholecystitis, intestinal obstruction, testicular torsion, deep laceration injuries, acute urinary retention, fractures, appendicitis, pleural effusion, upper GI bleeding, , cervical spine injuries [table 1] and the remaining 247 cases [35.1%] were non-emergencies (cold) cases. Of these 457 surgical emergencies, appendicitis accounted for 133 [ 29.10%] of cases making it the commonest surgical emergency that presented in our hospital in these two years.

Conclusion: The most common surgical emergency was acute appendicitis 133 cases [40.06%]followed closely by deep lacerations resulting from road traffic accidents 98 cases [25.83%] and head injuries 47cases [13.4%] among others This study also highlights the pattern of emergency surgical cases expected from the accident and emergency department of a typical private hospital which does not always mimic the pattern seen in other public hospitals. This information may help the management in recruiting appropriate staff for the surgical emergency unit/department of a teaching hospital

Keywords: Babcock University Teaching Hospital, Adult Accident and Emergency Unit, Surgical Emergency, Appendicectomy