Waiting time among acute abdominal emergencies in a Nigerian teaching hospital: causes of delay and consequences

Mbah, N; Opara, W. E. K.; Agwu, Ngwobia Peter

doi:10.4314/njsr.v8i1.54835

Cited by 14 publications

(24 citation statements)

References 8 publications

(16 reference statements)

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“…This result has a higher male to female ratio than that reported at Ibadan by Ajao 4. It is also in contrast with the finding from Sokoto by Mbah et al ,8 who reported intestinal obstruction as the commonest cause of acute abdomen.…”

Section: Discussioncontrasting

confidence: 76%

“…This may be the result of increase in the number of laparotomy being performed over the years. In Sokoto, however, post-operative adhesions were not found to be a significant cause of intestinal obstruction in the study by Mbah in 2006 8. Also, the study differs from the report by Ajao4 in which intussusception was the second leading cause of intestinal obstruction.…”

Section: Discussioncontrasting

confidence: 54%

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Pattern and presentation of acute abdomen in a Nigerian teaching hospital

2014

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Background:Abdominal pain of sudden onset is the hallmark of most non-traumatic emergency surgical presentations. This presents a scenario of urgency to the young surgeon who has to determine which of a myriad of disease conditions the patient is presenting with. Such a physician has to rely on experience and a sound knowledge of the local aetiological spectrum in making a clinical diagnosis.Objective:To determine the epidemiology and aetiological spectrum of diseases presenting as acute abdomen in the adult population at the hospital surgical emergency unit.Patients and Methods:Two hundred and seventy-six patients presenting at the University of Ilorin Teaching Hospital emergency unit and managed by the general surgeons between 1st of May 2009 and 30th of April 2010 were recruited and followed-up throughout the period of admission. The biodata and clinical information inclusive of diagnosis, investigations, treatment modality and outcome were entered in a structured questioner. Standardised treatment was given to all patients and difficulties encountered in their management were also noted. The data collected was evaluated using SPSS16.Results:Acute abdomen constituted 9.6% of total surgical emergency admissions with patients aged 16-45 years constituting 78.3%. The commonest cause of acute abdomen was appendicitis (30.3%) followed by intestinal obstruction (27.9%), perforated typhoid ileitis 14.9% and peptic ulcer disease (7.6%), respectively.Conclusion:The result from the study is similar to what has been reported in other tropical settings with inflammatory lesions being the major problem. There is also a rising incidence of post-operative adhesions and gradual decline in incidence of obstructed hernia.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussioncontrasting

confidence: 54%

Pattern and presentation of acute abdomen in a Nigerian teaching hospital

2014

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“…A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria 78910111213141516171819202122232425262728293031323334353637383940414243. A total of 11 publications (29.7%) were related to emergency surgery waiting times,7891011121314151617 10 (27%) were related to clinic waiting times,32333435363738394041 9 (24.3%) were related to day case surgery,232425262728293031 2 (5.5%) were related to investigation waiting times4243 and only 5 (13.5%) articles were specifically published on elective surgery waiting times 1819202122.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 11 publications (29.7%) were related to emergency surgery waiting times,7891011121314151617 10 (27%) were related to clinic waiting times,32333435363738394041 9 (24.3%) were related to day case surgery,232425262728293031 2 (5.5%) were related to investigation waiting times4243 and only 5 (13.5%) articles were specifically published on elective surgery waiting times 1819202122. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ENT, 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery.…”

Section: Resultsmentioning

confidence: 99%

“…7891011121314151617 This is not surprising, because there is currently a lot of focus on emergency care and surgery in many health centres in Nigeria. This may be a result of delayed presentation by patients, inadequate funding of the hospitals, lack of dedicated elective surgery services, lack of awareness among patients with non-urgent medical conditions and the general negative attitudes of the healthcare practitioners and managers towards non-urgent (elective) surgery.…”

Section: Discussionmentioning

confidence: 99%

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The surgical waiting time initiative: A review of the Nigerian situation

Abdulkareem

2014

Niger Med J

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SUMMARYThe concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7%) were related to emergency surgery waiting times, 10 (27%) were related to clinic waiting times, 9 (24.3%) were related to day case surgery, 2 (5.5%) were related to investigation waiting times and only 5 (13.5%) articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ear, nose and throat (ENT), 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5%) specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24.5%) publications were from obstetrics and gynaecology (O & G) alone, but these were mostly related to emergency antenatal care rather than surgery. Therefore, more research and initiative needs to be undertaken from all the surgical sub-specialties in order to disseminate this concept of SWAT towards early diagnosis and treatment of elective life-threatening conditions, as well as effective patient care. Adopting this concept will help healthcare managers and policy makers to stream line and ring face resources to cater for non-urgent or semi-urgent cases presenting to our hospitals in Nigeria.

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