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

Slonetsky B.I.,Verbytsky I.V.,Kotsyubenko V.O.,Berezenko I.M.

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

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

June 6, 2022

650

Keywords :

urgent surgical interventions

Specialities :

Surgery

Resume

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.

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