Surgical Audit of Operated Patients in a Tertiary Care Hospital in Karachi, Pakistan

Abstract

Objectives To audit operated patients in emergency and electively from 1st January 2018 to 31st December 2019 in all three surgical departments to know the outcome of the patients at a tertiary care hospital in Karachi, Pakistan. Material and Methods A retrospective study conducted in all three Abbasi Shaheed Hospital surgical units from 1st January 2018 to 31st December 2019. In this study total of 5079 patients were included who were admitted through the emergency and surgical outpatient department. They were operated in emergency and elective theaters in all three surgical departments of Abbasi Shaheed Hospital. Data was collected on pre-designed performa from emergency and elective theater, wards, High-dependency unit and Intensive care unit maintained registers by staff. Results A total of 5079 cases were operated during January 2018 to December 2019. Among all the age ranges 1282 belongs to the age range of 21-30 years. Amongst which 59.6% were males. The most common diagnosis made in elective patients was chronic calculous cholecystitis (25.8%) and an abscess in emergency (39.4%). The most common procedure performed in elective surgeries was combined laparoscopic and open cholecystectomy (26.8%) and incision and drainage in the emergency (39.4%). Elective surgeries were mainly performed by Associate Professors (28.7). While, emergency surgeries were mainly performed by post-graduate trainees (70.2%). Surgical unit II has performed most surgeries (39.5%). Elective procedure constitutes about (51.60%). Total 19 patients expired out of 350 patients who were shifted or admitted in surgical ICU and 12 patients expired in all three wards. Conclusion We have a higher number of elective surgeries as compared to the emergency surgeries. Consultants have performed most of the elective surgeries. Emergency surgeries mostly by residents and senior registrars. We have zero mortalities in our elective surgeries in comparison with emergency surgeries. We call attention to conduct continuous audits at our hospitals and all levels of health care and demand from higher authorized personnels to incorporate audit awareness in our teaching. Along with it, a proper database should be installed with updated records maintenance to improve the lack of health care.