The Quality and Utility of Surgical and Anesthetic Data at a Ugandan Regional Referral Hospital

• Published in: World journal of surgery 2017-02, Vol.41 (2), p.370-379
• Main Authors: Tumusiime, G., Was, A., Preston, M. A., Riesel, J. N., Ttendo, S. S., Firth, P. G.
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adolescent; Adult; Aged; Cardiac Surgery; Child; Congenital Condition; Data Collection; Female; General Surgery; Hospitals, Rural; Humans; Male; Medical Record Number; Medicine; Medicine & Public Health; Middle Aged; Operative Care; Original Scientific Report with Video; Quality Improvement; Referral and Consultation; Regional Referral Hospital; Senior House Officer; Surgery; Surgical Procedures, Operative - statistics & numerical data; Thoracic Surgery; Uganda - epidemiology; Vascular Surgery; Wounds and Injuries - epidemiology; Wounds and Injuries - surgery; Young Adult
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-016-3714-8

Background There are little primary data available on the delivery or quality of surgical treatment in rural sub-Saharan African hospitals. To initiate a quality improvement system, we characterized the existing data capture at a Ugandan Regional Referral Hospital. Methods We examined the surgical ward admission (January 2008–December/2011) and operating theater logbooks (January 2010–July 2011) at Mbarara Regional Referral Hospital. Results There were 6346 admissions recorded over three years. The mean patient age was 31.4 ± 22.3 years; 29.8 % ( n  = 1888) of admissions were children. Leading causes of admission were general surgical problems ( n  = 3050, 48.1 %), trauma ( n  = 2041, 32.2 %), oncology ( n  = 718, 11.3 %) and congenital condition ( n  = 193, 3.0 %). Laparotomy ( n  = 468, 35.3 %), incision and drainage ( n  = 188, 14.2 %) and hernia repair ( n  = 90, 6.8 %) were the most common surgical procedures. Of 1325 operative patients, 994 (75 %) had an ASA I–II score. Of patients undergoing 810 procedures booked as non-elective, 583 (72 %) had an ASA “E” rating. Records of 41.3 % (n-403/975) of patients age 5 years or older undergoing non-obstetric operations were missing from the ward logbook. Missing patients were younger (25 [13,40] versus 30 [18,46] years, p  = 0.002) and had higher ASA scores (ASA III-V 29.0 % versus 18.9 %, p