Emergency general surgery in a public hospital in Malaysia
- Author:
Kandasami Palayan
1
;
Yita Tang
1
;
Chi Xuan Sam
1
;
Chern Wayne Kee
1
;
Muhammad Naim Rusman
1
;
Afifah Aflah Mohd Derus
1
;
Mahadevan Deva Tata
2
Author Information
- Publication Type:Journal Article
- Keywords: General Surgery; Emergency Surgery; Out of hours; Outcomes
- From: The Medical Journal of Malaysia 2020;75(5):467-471
- CountryMalaysia
- Language:English
- Abstract: 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.
