1.Emergency general surgery in a public hospital in Malaysia
Kandasami Palayan ; Yita Tang ; Chi Xuan Sam ; Chern Wayne Kee ; Muhammad Naim Rusman ; Afifah Aflah Mohd Derus ; Mahadevan Deva Tata
The Medical Journal of Malaysia 2020;75(5):467-471
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.