Surgical Diagnoses Presented in the Emergency Room

Abstract

bstract Degree Project, Programme in Medicine, Surgical Diagnoses Presented in the Emergency Room - A cross-sectional study in two tertiary hospitals in Kathmandu, Nepal, Emma Haskovec, University of Gothenburg, Sweden, May 2017. Supervisors: Prof. Göran Kurlberg and Prof. Pratap Narayan Prasad Background: The surgical diagnoses presented in the emergency room range from symptoms in need of surgical treatment to traumas after various forms of accidents. A better understanding of the conditions that drive patients to seek acute care in low-and middleincome countries (LMICs) is crucial to strengthen emergency care in those countries. Aim: This study aimed to describe the most common surgical diagnoses presented in the emergency room of Nepal and to investigate if gender affected the type of surgical diagnosis (traumatic/non-traumatic) or the management of the patients. Methods: This cross-sectional study was conducted in the emergency room of two tertiary level hospitals in Kathmandu, Nepal. The study population consisted of 1787 emergency patients with surgical diagnoses, diagnosed in March 2017. Information regarding age, gender, district of origin, triage, diagnosis and management were collected from ledgers, triage area records and medical records. Then, all doctor-assigned diagnoses were retrospectively classified using the Clinical Classifications Software (CCS) for International Classification of Diseases, Tenth Revision (ICD-10) in order to group diagnoses into clinically meaningful categorise. Results: The three most common surgical diagnoses were superficial injury; contusion, calculus of urinary tract and fracture of upper limb. The frequency varied by gender, with the addition of gynaecological diagnoses for females, and a significant difference regarding traumatic diagnoses. Significantly more males than females suffered from traumatic injuries, p <0.0001. Additionally, females were more probable to be discharged than males, p = 0.005. Conclusion: This data suggests that type of surgical diagnosis (traumatic/non-traumatic) vary by gender, partly due to different spectrums of diagnoses. Thus, a better understanding of the surgical emergencies that physicians encounter has been provided through this study, which could help future research, prioritization of resources and development of the emergency department.