Comparative Multicenter Analysis of the Early Postoperative Complications Causes in Emergency Abdominal Surgery

Abstract

Results of a multicenter study of the frequency of reinterventions after emergency abdominal operations in various segments of the surgical service presented. Study included three groups, where the first group consisted of patients operated at the V.Vahidov Republican Specialized Center of Surgery (252 patients), the second group - 176 patients treated in regional and urban health care clinics, and the third group - 77 patients operated on in the district hospitals. The main goal of this research was statistical evaluation of the frequency of repeated interventions in the various clinics of the Republic in the last years depending on the pathology and hence the nature and complexity of the primary operation. The analysis showed, that in a multilevel system of surgical care in the Republic on the district, regional and city levels dominates the spectrum of "ordinary" general surgical interventions - 99.7% and 94.9%, respectively, in turn, at the Republican Center 48.8% ofinterventions are the complex high-tech and specialized operations. Stratified analysis of the relaparotomy rate in district hospitals showed that, after general surgery operations average frequency of repeated surgery was 2.78%, and after the high-tech operations reaching 5.65%; at the level of city and regional institutions - 2.18% (p<0.001 for regional group) and 3.82%(p<0.001), respectively, and after the special operations reaches 22.23%; at the Republican Center an average frequency of reinterventions after general surgical operations was 1.86% (p<0.001 compared to the other groups), after the high-tech operations - 3.29% (p<0.001) and after a specialized operations - 21.72% (p<0.01 compared with groups of city and regional institutions).

Keywords

• emergency abdominal operations
• complications
• repeated surgery.