Khanapure Shubhada, Nagral Sanjay, Nanavati Aditya J
K.B. Bhabha General Hospital, Bandra (West), Mumbai 400050, Maharashtra, India.
Natl Med J India. 2017 Mar-Apr;30(2):65-68.
Acute abdomen is a common surgical emergency. Prompt investigation and treatment, including surgical intervention, is critical in reducing morbidity and mortality.
We carried out a prospective observational study at a large urban secondary healthcare centre in India. Patients with surgical acute abdomen were consecutively enrolled in the study over a period of 2 years. Data were collected regarding the onset of symptoms, time of presentation to the hospital and events in the intervening period.
Analysis showed that misdiagnosis by medical personnel was significantly associated with delay in admission to the hospital. Unfamiliarity with the medical facilities, ignorance, low education and illiteracy and public holiday were the contributing factors for delayed presentation. Even though we detected some trends, the delay was not significantly associated with age, sex, educational level or socioeconomic status of the patient. The delay resulted in an increased mortality and morbidity especially in patients who needed emergency operative management.
Delayed presentation of acute abdomen is often not due to a single reason. The causes are distributed over various levels starting from the patient, family, medical personnel, administrative deficiencies, socioeconomic and sociocultural status of the country.
急腹症是一种常见的外科急症。及时进行检查和治疗，包括手术干预，对于降低发病率和死亡率至关重要。
我们在印度一家大型城市二级医疗中心开展了一项前瞻性观察研究。连续2年纳入患有外科急腹症的患者进行研究。收集了有关症状发作、到医院就诊时间以及其间发生事件的数据。
分析表明，医务人员的误诊与入院延迟显著相关。对医疗设施不熟悉、无知、教育程度低和文盲以及公共假日是导致就诊延迟的因素。尽管我们发现了一些趋势，但延迟与患者的年龄、性别、教育程度或社会经济地位并无显著关联。这种延迟导致死亡率和发病率增加，尤其是在需要紧急手术治疗的患者中。
急腹症就诊延迟往往并非单一原因所致。其原因分布在从患者、家庭、医务人员、管理缺陷到国家社会经济和社会文化状况等各个层面。
