Identifying the Patterns: Prevalence and Management of Trauma and Surgical Emergencies in a Tertiary Care Hospital in Peshawar

识别模式:白沙瓦一家三级医院创伤和外科急症的患病率和管理

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Abstract

Introduction Surgical emergencies are considered a significant part of the overall healthcare burden that usually require timely evaluation and urgent intervention to prevent complications and mortalities. The surgical emergency room (SER) is part of the accident and emergency bay that provides care to patients presenting with acute injuries and non-traumatic surgical complaints. The objective of our study was to investigate the patterns of all diseases presenting to the SER and the differences in treatment and outcomes of patients based on trauma vs. non-trauma complaints. Methods We performed a prospective descriptive study at the SER from March 1, 2023, to March 15, 2023. Patients of all ages and either gender presenting to the SER with any complaint during the data collection period were included. Patients were stratified into two groups: Group T (trauma) and Group NT (non-trauma). These groups were compared for baseline characteristics and outcomes. Descriptive statistics were used to summarize the findings. Analyses were conducted to compare trauma vs. non-trauma patients in terms of baseline characteristics, management, and outcomes. A p-value less than 0.05 was considered statistically significant. Results A total of 550 patients were analyzed, with 97 (17.6%) in Group T and 453 (82.4%) in Group NT. The mean ± SD age was 31.1 ± 17.7 years, with a male predominance (n = 352, 64.0%). Abdominal pain was the most common presentation (n = 172, 31.3%), followed by trauma (n = 97, 17.6%). There was no statistically significant difference in baseline characteristics and comorbid conditions between trauma and non-trauma patients (p > 0.05). However, trauma patients more frequently received intravenous (IV) analgesics (T: 75 [77.3%] vs. NT: 135 [29.8%], p < 0.001) and IV fluids (T: 78 [80.4%] vs. NT: 107 [23.6%], p < 0.001). Non-trauma patients received more IV antibiotics (T: 20 [20.6%] vs. NT: 155 [34.2%], p = 0.012) and oral analgesics (T: 45 [46.4%] vs. NT: 280 [61.8%], p = 0.004). Critical interventions were more frequent in the trauma group, including chest intubation (T: 5 [5.2%] vs. NT: 0, p < 0.001) and endotracheal intubation (T: 7 [7.2%] vs. NT: 2 [0.4%], p < 0.001). There was no significant difference in the rates of major surgeries (p > 0.05). ICU admissions (T: 25 [25.8%] vs. NT: 10 [2.2%], p < 0.001) and mortality (T: 4 [4.1%] vs. NT: 1 [0.2%], p = 0.003) were higher among trauma patients. Conclusion This study offers a detailed overview of surgical emergencies in a tertiary care hospital in Pakistan, highlighting patterns that both mirror and differ from international data. Beyond the description of disease presentations, we compare the management strategies and outcomes of patients based on trauma-related versus non-trauma complaints. Our findings may serve as a reference for future research and development of treatment guidelines for surgical emergencies.

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