Open AccessA STUDY OF NON-PATIENT FACTORS CONTRIBUTING TO RUPTURED APPENDICITIS IN SWAT.
Author(s) -
Manzoor Ali,
Muhammad Delwar Hussain,
Samieullah,
Muhammad Usman,
Ismail ISMAIL,
Mohammad Naseem
Publication year - 1969
Publication title -
journal of saidu medical college
Language(s) - English
Resource type - Journals
ISSN - 1819-4583
DOI - 10.52206/jsmc.2012.2.1.117-126
Subject(s) - medicine , appendicitis , peritonitis , emergency surgery , general surgery , medical record , health care , emergency medicine , medical emergency , surgery , economics , economic growth
Background: Ruptured appendicitis is still prevalent. Adult rates of ruptured appendicitis vary from 13.2to 41.9 percent in bigger hospitals, despite controlling for individual factors like age, sex, co morbidity andsocioeconomic status. This suggests an effect of hospital organization. Surgeons report thatappendicectomies may be delayed because of lack of access to operating theater.Methods: Combining interviews with hospital personnel and information from the medical record, foryear 2011, a cross sectional study was conducted on 4305 patients. Four hospitals were included in thestudy. The diagnostic information was recorded to ensure inter hospital validity. Results: Hospital withhigh activity and volume of patients, but without an operation theatre designated for urgent surgery, wasassociated with a significant higher rate of peritonitis (P=< 0.050). Time to surgery after departure fromAccident and Emergency department, was very long in hospital having no operating theater for urgentsurgery particularly elderly patients.Conclusion: Hospital characteristics in unfavorable combinations influence the course of time-dependentdisease such as appendicitis. Difficulties in gaining access to operating theater, even for urgent operations,have emerged. Delays in treatment must be addressed when planning healthcare reforms.Keywords: Perforated appendicitis, peritonitis, urgent surgery