Article ; Online: The Burden of Emergency Abdominal Surgery Heavily Outweighs Elective Procedures in KwaZulu-Natal Province, South Africa.
The Journal of surgical research
2020 Volume 259, Page(s) 414–419
Abstract: Background: South Africa is a middle-income country with major discrepancies in wealth and access to care. There is a significant burden of surgical disease and limited access to quality health care for a large proportion of the population. This article ...
| Abstract | Background: South Africa is a middle-income country with major discrepancies in wealth and access to care. There is a significant burden of surgical disease and limited access to quality health care for a large proportion of the population. This article quantifies the burden of abdominal surgery over a 6-month period in KwaZulu-Natal (KZN) province and quantifies the emergency to elective (Ee) ratio for these operations. Methods: This study describes the abdominal operations conducted at all regional and tertiary hospitals in the public health sector of KZN province for the period of 1 July to December 31, 2015. Operations performed were tabulated in a spreadsheet and categorized as elective, emergency, and trauma. They were further subdivided by anatomical region and by specific predetermined procedures. Uncertain criteria were clarified using a modified Delphi discussion. The Ee ratio was determined using the recently described technique. Results: Between June, 1st and December 31, 2015, of 13,282 operations, there were 4580 (34.5%) elective operations, 7777 (58.6%) emergency operations, and 925 (6.9%) trauma-related operations. A total of 5630 abdominal operations were performed of which 2949 were emergency procedures. There were 660 trauma-related abdominal procedures and 2021 elective procedures. There was a heavy weighting toward emergency surgeries with an Ee ratio of 145 for abdominal surgery. The previous sub-Saharan African ratio was estimated to be 62.6. Conclusions: An overview of abdominal surgery in KZN reveals a high ratio of emergency to elective surgery. This suggests that the current primary health care program is failing to detect and treat acute surgical disease timeously. |
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| MeSH term(s) | Abdominal Cavity/surgery ; Abdominal Injuries/surgery ; Elective Surgical Procedures/statistics & numerical data ; Emergency Treatment/methods ; Emergency Treatment/statistics & numerical data ; Geography ; Health Services Accessibility ; Humans ; South Africa ; Tertiary Care Centers/statistics & numerical data |
| Language | English |
| Publishing date | 2020-10-23 |
| Publishing country | United States |
| Document type | Journal Article ; Multicenter Study |
| ZDB-ID | 80170-7 |
| ISSN | 1095-8673 ; 0022-4804 |
| ISSN (online) | 1095-8673 |
| ISSN | 0022-4804 |
| DOI | 10.1016/j.jss.2020.09.013 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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