Surgical diagnoses and post-operative outcomes of intestinal obstruction among adults in regional referral hospitals, in Dares-Salaam, Tanzania
Loading...
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Hubert Kairuki Memorial University
Abstract
Background: There is limited available published information regarding the surgical outcomes of intestinal obstruction among adult patients in Dar-es-salaam regional referral hospitals. Objective: To assess the surgical diagnoses and outcomes of intestinal obstruction among adult patients treated in the regional referral hospitals in Dar-es-salaam - Tanzania. Study design: Observational hospital based prospective study. Study settings: Dar-es-salaam regional referral hospitals (Amana,Mwananyamala& Temeke) Study duration: December 2021 to July 2022. Methods: Data were collected using a pre-validated clinical sheet. All adult patients with post-operative surgical diagnoses of intestinal obstruction at Amana, Mwananyamala and Temeke hospitals were recruited. Data were analyzed using SAS (statistical analytical software) version 9.7. Results: The study analysed 228 adult males and females with an average of 1411 patients-days of follow-up covering the period of December 2021 to July 2022 (inclusive).The median age was 47(IQR: 3-6) days.During the study period, 12 patients (5.26%) died,20 (9%)had surgical site infection, 2(0.9%)had wound dehiscence while 1 (0.4%)had anastomotic leak. Intra-operative findings identified for intestinal obstruction included adhesions(OR=5.66, 95% C.I. = 4.3-7.1), abdominal tumors(OR=1.028, 95% C.I. = 1.02 – 1.12),hernia(OR=2.04, 95% C.I.= 1.01 – 6.23) and volvulus (OR=4.2, 95%C.I.=3.1 – 5.0).There were no statistically significant differences (χ2 test value = 4.992; df= 10, p value = 0.8997) In specific surgical outcomes of deaths, discharged, sepsis, and/or abscondment among the studied hospitals. Conclusion: Adhesions, abdominal tumors, hernia and volvulus were the most frequent intraoperative causes. About one-in-twenty of all followed-up patients died during the study period. Almost one-in-ten of all followed-up patients had evidence of post-operative complications. There was no evidence of hospital effects for surgical outcomes in this study. Recommendations: The relatively high mortality rate found in this study has to be worked upon by further studies to reduce it. For the unknown post-operative patients, about one in twenty
Description
A dissertation submitted in partial fulfillment of Master of Medicine degree in Surgery of Hubert Kairuki Memorial University September 2022
Keywords
Intestinal obstruction, Prospective, Dar es Salaam
Citation
Mponzi, S.S., 2022. Surgical diagnoses and post-operative outcomes of intestinal obstruction among adults in regional referral hospitals, in Dares-Salaam, Tanzania.HKMU.