Outcome of casualty room care for surgical emergencies presenting to university teaching hospital

Abstract

The outcome of Casualty care in surgical emergencies is critical to assessing not only the preparedness to handle emergencies but also the quality of care a hospital renders since the Casualty is a major entry point for patients into the hospital especially emergencies. The purpose of this study was to ascertain the outcome of casualty room care for surgical emergencies presenting to the University Teaching Hospital. METHODS: A prospective cross-sectional observational study in which consecutive patients with surgical emergencies presenting to University Teaching Hospital between July 2016 and Feb 2017 were recruited and data entered in a structured proforma. Data sought included: age, sex, occupation, level of education, religion, marital status, nature of surgical emergency and outcome of casualty room care. RESULTS: 390 patients were admitted in Casualty within the study period. 72.3% were males; 27.7%, females. 55.9% were in the third and fourth decade of life. Fractures and traumatic brain injur constituted majority of the cases with 130 (33%). Time between presentation and review by both the casualty officer and the subspecialty team on-call ranged from 1-55 minutes and 2-4 hours respectively. 57.7% were discharged from the Casualty either to the Surgical Out-Patient Department or home. 19.7% Left against Medical Advice (LAMA); mortalities constituted 6.7%; 4.4% were referred out either on request or to regional sub-speciality centres; while 1.8% had emergency surgeries. CONCLUSION: Trauma was the leading cause of surgical emergencies. A good number of the patients were discharged from the Casualty; a good number left against medical advice while the mortalities were within the reported figures for similar studies in the region. A few had emergency surgeries.