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World Journal of Surgery
Published in: World Journal of Surgery 2/2017

01-02-2017 | Original Scientific Report with Video

The Quality and Utility of Surgical and Anesthetic Data at a Ugandan Regional Referral Hospital

Authors: G. Tumusiime, A. Was, M. A. Preston, J. N. Riesel, S. S. Ttendo, P. G. Firth

Published in: World Journal of Surgery | Issue 2/2017

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Abstract

Background

There are little primary data available on the delivery or quality of surgical treatment in rural sub-Saharan African hospitals. To initiate a quality improvement system, we characterized the existing data capture at a Ugandan Regional Referral Hospital.

Methods

We examined the surgical ward admission (January 2008–December/2011) and operating theater logbooks (January 2010–July 2011) at Mbarara Regional Referral Hospital.

Results

There were 6346 admissions recorded over three years. The mean patient age was 31.4 ± 22.3 years; 29.8 % (n = 1888) of admissions were children. Leading causes of admission were general surgical problems (n = 3050, 48.1 %), trauma (n = 2041, 32.2 %), oncology (n = 718, 11.3 %) and congenital condition (n = 193, 3.0 %). Laparotomy (n = 468, 35.3 %), incision and drainage (n = 188, 14.2 %) and hernia repair (n = 90, 6.8 %) were the most common surgical procedures. Of 1325 operative patients, 994 (75 %) had an ASA I–II score. Of patients undergoing 810 procedures booked as non-elective, 583 (72 %) had an ASA “E” rating. Records of 41.3 % (n-403/975) of patients age 5 years or older undergoing non-obstetric operations were missing from the ward logbook. Missing patients were younger (25 [13,40] versus 30 [18,46] years, p = 0.002) and had higher ASA scores (ASA III-V 29.0 % versus 18.9 %, p < 0.001) than patients recorded in the logbbook; there was no diffence in gender (male 62.8 % versus 67.0 %, p = 0.20).

Conclusions

The hospital records system measures surgical care, but improved data capture is needed to determine outcomes with sufficient accuracy to guide and record expansion of surgical capacity.
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Metadata
Title
The Quality and Utility of Surgical and Anesthetic Data at a Ugandan Regional Referral Hospital
Authors
G. Tumusiime
A. Was
M. A. Preston
J. N. Riesel
S. S. Ttendo
P. G. Firth
Publication date
01-02-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 2/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3714-8

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