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Advertising in the issue 1-2 (147-148) – I/IV 2022
  • All electronic publications
2022-06-06 :
  • Research article

Negative components of diagnostic and treatment tactics in patients with acute surgical diseases of the abdominal cavity with fatal consequences

Slonetsky B.I.1, Verbytsky I.V.2, Kotsyubenko V.O.1, Berezenko I.M.3

  • 1Bogomolets National Medical University, Kyiv, Ukraine
  • 2Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
  • 3Kyiv City Clinical Emergency Hospital, Kyiv, Ukraine

Summary. The article presents the results of the analysis of staged diagnosis and treatment of 422 patients with acute surgical diseases of the abdominal cavity with a fatal outcome. The structure of the root causes that led to death was: gastrointestinal bleeding in 173 (41%), peritonitis in 72 (17.6%), acute vascular diseases of the intestine in 51 (12.09%), complications of gastrointestinal cancer in 30 (7.11%) patients; elderly and senile patients were dominated (223; 52.84%) and mostly men (225; 53.32%). Analysis of the period of hospitalization from the moment of the disease to the medical hospital showed that 287 (68.1%) patients were hospitalized 1 day after the disease, according to the degree of operative-anesthesiological risk according to the scale of the American Society of Anesthesiologists every 3rd (107; 38.63%) patient was III and IV degree, and the term of arrival of the ambulance to 176 (41.71%) patients was in the period from 10 minutes to 1 hour, to 191 (45.26%) patients — exceeded 1 hour. In the city of Kyiv in 2021, emergency medical care was provided by understaffed doctors at the pre-hospital stage by 29.7%, at the hospital stage — 34.78%, and the replacement of doctors at the pre-hospital stage by paramedics led to comprehensive antishock therapy only in 9 (4.35%) of 207 patients.

УДК 55-089.15(477-25)
DOI: 10.32471/umj.1680-3051.149.229493

References

  • 1. Державний заклад «Центр медичної статистики Міністерства охорони здоров’я України». Звіт про медичні кадри. medstat.gov.ua/ukr/statdan.html.
  • 2. Полянський І.Ю., Мороз П.В., Москалюк В.І. та ін. (2017) Лікування перитоніту — шлях від доказової до персоналізованої медицини. Харківська хірургічна школа, 1(82): 59–63.
  • 3. Матеріали ХХІV з’їзду хірургів України: Зб. наук робіт. Відповідальний за випуск О.Ю. Усенко. Київ, Клін. хірургія, 2018. 596 с.
  • 4. Снегирев Ф.Г. (2019) Поступ і майбуття української хірургії. Укр. мед. журн., 1(1)(129): www. umj.com.ua/article/138400/postup-i-majbuttya-ukrayinskoyi-hirurgiyi.
  • 5. Фомін П.Д., Матвійчук О.Б. (2017) Третинний перитоніт як проблема абдомінальної хірургії. Клінічна хірургія, 11(908): 77–79.
  • 6. Berrios-Torres S.I. (2017) Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. J. Am. Med. Assoc. Surgery, 152(8): 784–791.
  • 7. Burcharth J., Abdulhady L., Danker J. et al. (2019) Implementation of a multidisciplinary perioperative protocol in major emergency abdominal surgery. Eur. J. Trauma Emerg. Surg., DOI: 10.1007/s00068-019-01238-7.
  • 8. Fang X., Wang Z., Yang J. et al. (2018) Clinical Evaluation of Sepsis-1 and Sepsis-3 in the Intensive Care Unit. Chest, 153(5): 1169–1176.
  • 9. Dobson G.P. (2020) Trauma of major surgery: A global problem that is not going away. Int. J. Surg., 81: 47–54. doi: 10.1016/ j.ijsu.2020.07.017.
  • 10. Nally D.M., Sørensen J., Valentelyte G. et al. (2019) Volume and in-hospital mortal-ity after emergency abdominal surgery: a national population-based study. BMJ Open, 9(11): e032183. DOI: 10.1136/bmjopen-2019-032183.
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Full article in pdf format
Keywords:
abdominal organs, abdominal surgery, urgent surgical interventions
Specialties:
Surgery
Views: 3
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