Abstract
ABSTRACTBackgroundThere is limited available published information regarding surgical diagnoses and post-operative outcomes of intestinal obstruction among adult patients in East African hospitals. The observation is despite available anecdotal evidence of the condition to be among the commonest surgical emergencies in the area.ObjectiveTo assess the surgical diagnoses and outcomes of intestinal obstruction among adult patients treated at the regional referral hospitals in Dar-es-salaam - Tanzania.Methods & FindingsThis was a prospective, observational, hospital-based study. Data were collected using a pre-validated Clinical Research Form (CRF). All adult patients with post-operative surgical diagnoses of intestinal obstruction at Amana, Mwananyamala and Temeke hospitals in Dar es Salaam were the target population. Data were analyzed using a generalized linear model via SAS version 9.7. Multivariable logistic regression model was the final fitted model. Intra-operative findings (surgical diagnoses) of intestinal obstruction was an outcome variable. Unless otherwise stated, an α-level of 5% was used as a limit of type 1 error in findings. The study analysed an average of 1411 patients-days of follow-up. Participants’ median age and duration of hospital stay were 47 (IQR: 35-67) years and 4 (IQR: 3-6) days respectively. Intra-operative findings included adhesions (aOR=5.66), abdominal tumors (aOR=1.028), hernia (aOR=2.04) and volvulus (aOR=4.2). Moreover, 12 (5.26%) clients died and 20 (9%) had surgical sites infection. No statistically significant difference of hospital on surgical outcomes (χ2test value = 4.992; df = 10).ConclusionAdhesions was the commonest intraoperative cause of intestinal obstruction in this study population. One-in-twenty of all followed-up clients died. Significant proportion of patients had evidence of post-operative complications.
Publisher
Cold Spring Harbor Laboratory