Delay of emergency surgical interventions in Ethiopia: Patient and health system factors
Bibliographic record
Abstract
Background: The objectives of this study were to evaluate outcomes among patients with acute abdomen and abdominal trauma who presented at either of 2 referral hospitals in Addis Ababa, Ethiopia, and to determine the factors associated with delay as well as the effects of prehospital and in-hospital delay on outcome. Methods: We conducted a 1-year prospective cross-sectional study, which included all cases of surgically treated acute abdomen and abdominal trauma admitted to St Paul General Specialized Hospital, Addis Ababa, Ethiopia and Gondar University Hospital, Gondar, Ethiopia. Standardized data collection forms were completed for all cases from 1 May 2008 to 30 April 2009. Data were analyzed using Epi Info version 6 and SPSS version 13. Results: A total of 504 patients were studied. Diagnoses were: intestinal obstruction (34.6 %), appendicitis (33 %), and perforated peptic ulcer (3.6 %). Sixty-six percent of patients over 45 years of age, 60% of females, and 61% of intestinal obstruction cases were operated on within 3 days of illness onset. The 35% of patients who were operated on more than 3 days after the development of symptoms had a mortality of 67%. Fifty-four percent of the cases with a total prehospital and in-hospital time of more than 3 days had initially visited other health institutions. Conclusions: Delay of surgical intervention of more than 3 days for acute abdomen or abdominal trauma adversely affected outcomes. Women, patients older than 45 years of age, patients with intestinal obstruction, and those who were referred from other health facilities were delayed and had adverse outcomes. Keywords: delay in surgery; acute abdomen; abdominal trauma; surgical systems improvement
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".