Surgical emergencies in Ireland. An audit of the emergency surgical caseload of an Irish district general hospital.
Emergency cases are an increasing part of the workload of a general surgical unit. Little accurate quantitative data is presently available on the nature and impact of this workload on a typical district general surgical service. This study reports the results of a prospective one year audit of the emergency cases dealt with by a typical Irish district general surgical service. The general surgical service admitted 2,278 patients acutely, which represented 58% of the total number of admissions to the service. Eighteen patients required immediate transfer for specialist neurosurgical (11), vascular (6) or plastics (1) treatment. Of those cases admitted 1,396 (61.3%) were males and 882 (38.7%) were females. There were 1,786 (78%) adults and 492 (21.6%) paediatric cases. Abdominal pain (48.0%), head injury (23.8%) and urological problems (11.0%) accounted for the majority of the caseload. Within the abdominal pain group, the pre-dominant diagnoses were non-specific abdominal pain (36.0%), appendicitis (19.5%), cholecystitis/obstructive jaundice (10.8%) and peptic ulcer disease (10.0%). There were 456 emergency operations performed, representing 19.5% of all the inpatient general surgical procedures. 328 (72%) of these were performed out of normal working hours. Only 12% of the procedures were major. The commonest operations were appendicectomy (51%), abscess drainage (13%), wound toilet (13%) and laparotomy (11%). The emergency peri-operative mortality was 1.1%. The positive appendicectomy rate was 92%.
Davies
M G
MG
Department of Surgery, International Missionary Training Hospital, Drogheda, Ireland.
Shine
M F
MF
Lennon
F
F
D004630:Emergencies / Q000453:epidemiology*; D006745:Hospital Bed Capacity, 300 to 499; D017052:Hospital Mortality; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D013514:Surgical Procedures, Operative / Q000401:mortality / Q000706:statistics & numerical data*; D014600:Utilization Review / Q000706:statistics & numerical data*; D016526:Workload