Pattern of surgical admissions to Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A five-year retrospective study

Abstract

Background: Tikur Anbessa specialized hospital (TASH) is Ethiopia’s largest tertiary teaching and referral hospital admitting and treating surgical patients under various specialties. This study aims to analyze the magnitude and pattern of surgical admissions to this facility. Methods: A five-year Cross sectional retrospective analysis was done on all adult surgical admissions to TASH from Sept. 2010 to Sept. 2015. Results: There were a total of 8,698 surgical admissions of which, 4471 (51.4%) were male and 4227 (48.5%) were female with male to female ratio of 1.06:1. Their age ranged from 13 to 95, with mean age being 38.8 ± 16.2 years. Three thousand two hundred twenty two (46.5%) patients were from Addis Ababa. Of all admissions, 4706 (54.1%) were elective ones of which obstructive uropathy, 997(21.1%), esophageal diseases, 716(15.2%) and Urolithiasis, 573(12.2%) respectively are the top three. The rest, 3992 (44.9%), were emergency admissions, the top three ones being trauma, 1435(35.9%), appendicitis 281(7%) and Intestinal obstruction, 190(4.7%) respectively. General surgical (gastrointestinal, endocrine and vascular) cases account for 3414 (39.25%) of all admissions followed by urosurgical cases, 2114 (25.31%), cardiothoracic surgical cases, 1942 (22.33%), and neurosurgical cases, 1139 (13.1%). There were a total of 280 deaths with an overall mortality rate of 4% of which, 3.2% were from elective admissions and 5.2% from emergency ones. Mortality rate was the highest among neurosurgical patients being 6.3% followed by 4.3%, 3.8% and 3.5% in cardiothoracic, general surgical and urosurgical cases respectively. Conclusions: The admission pattern indicates quite a big number and diversity of cases though the bed capacity is limited. There are significant number of cases that could be treated at other secondary level hospitals. Trauma is the leading cause of emergency admissions and significant cause of mortality. We recommend increasing the number of beds, organizing separate trauma center and admitting only cases requiring tertiary level care. Keywords: pattern of surgical diseases; surgical admissions; Tikur Anbessa Specialized Hospital

Epidemiology and causes of intestinal obstruction in Ethiopia: A systematic review

“…52 In addition, studies have illustrated that advanced age, medications altering intestinal motility, chronic constipation, consumption of high fiber diets, 73 history of abdominal surgery, neurological or psychiatric illness, pregnancy, high altitude, and megacolon contribute to sigmoid volvulus. 4,33,38…”

“…52 In addition, studies have illustrated that advanced age, medications altering intestinal motility, chronic constipation, consumption of high fiber diets, 73 history of abdominal surgery, neurological or psychiatric illness, pregnancy, high altitude, and megacolon contribute to sigmoid volvulus. 4,33,38 Globally, colon cancer is the third most commonly diagnosed cancer in males and the second among females. 74 Also, it is the fourth most frequently diagnosed cancer.…”

“…6,7 Although the shreds of evidence illustrate a pattern change in Africa, little is known about the underlying causes. 8–10 Despite the above estimations of the global prevalence of intestinal obstruction, it was not well-documented in Ethiopia. However, national evidence on the magnitude of intestinal obstruction is required to make informed health policy decisions.…”

Patient satisfaction with post-operative pain management and associated factors among surgical patients at Tikur Anbessa Specialized Hospital: Cross-sectional study

“…This work is reported in line with STROCSS criteria from www.strocssguideline.com [ 11 ]. To date, postoperative pain was controlled according to national guidelines, particularly using pethidine, tramadol, and diclofenac prescribed by the surgeons and provided by nurse wards at study area [ 12 ]. The study included all adult patients who had undergone elective surgery during the study period at TASH.…”

Neurotrauma from fall accidents in Ethiopia

“…Trauma is a significant concern for the country, and its fast-growing economy may exacerbate the situation ( Bank, 2020 ; James et al, 2020 ). Falls are the most common cause of unintentional injuries among all emergency outpatient visits in Addis Ababa, ( Wolde et al, 2008 ) but falls receive less attention than RTAs ( Ali et al, 2020 ). Assaults, followed by RTAs and falls, are the most common injury mechanisms requiring neurosurgical interventions in the country, with falls from height being the leading cause of SCI ( Laeke et al, 2021b ; Biluts et al, 2015 ).…”