Mbowella Amos, Mchembe Mabula, Massawe Godbless, Mwanga Ally, Msoffe Irene A
Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Muhimbili National Hospital, Dar es Salaam, Tanzania.
East Afr Health Res J. 2024;8(2):200-207. doi: 10.24248/eahrj.v8i2.782. Epub 2024 Jun 26.
Postoperative complications are a leading cause of morbidity and mortality to surgical patients. Different complications are encountered in clinical practice, however surgical site infection (SSI) appears to be the most common. To date, limited published information is known pertaining to the patterns of postoperative complications and factors associated with SSI among patients operated on in other hospitals in Tanzania and referred to Muhimbili national hospital for further management. Therefore, the purpose of this study was to identify patterns of postoperative complications and factors associated with SSI among the study participants.
This was a hospital based cross-sectional study conducted at Muhimbili national hospital from August 2022 to January 2023, which included 181 patients. Obtained data was analysed using frequency tables, Pearson Chi-squared test and binary logistic regression model, at a level of significance of <0.05.
One hundred eighty one (181) patients were included in this study, of whom 113(62.4%) were females; median age was 39 years. Cigarette smokers and alcohol consumers were 42(23.2%) and 90(49.7%) respectively. Diabetic patients were 8(4.4%), 35(19.3%) were HIV positive and 52(28.7%) had hypertension. Patients whose diagnosis was related to general surgery accounted for 50.2%, whereas 30.9% were obstetric cases. Patients who had undergone Caesarean section were 45(24.9%), whereas 20(11%) patients had undergone total abdominal hysterectomy. Bowel resection and primary anastomosis included 16(8.8%) patients and perforated peptic ulcer repair 8(4.4%) patients. Patients with infected peritoneal collection were 34(18.8%), postpartum haemorrhage 18(9.9%) and bowel perforation 10(5.5%). Patients who had undergone relaparotomy as part of treatment were 70(38.7%), whereas 30(16.6%) patients with SSIs were treated by serial wound dressing and 26(14.4%) patients were admitted and nursed in intensive care unit. None of the factors was found to have a statistically significant association with SSI.
There is a large proportion of patients suffering from postoperative complications after gastroenterology and obstetric surgeries; and of all complications encountered in this study; SSI was the most common contributing 52%, followed by gastrointestinal complications at 31%. Despite the fact that multiple factors were associated with SSI, none of them was found to be statistically significant.
术后并发症是外科患者发病和死亡的主要原因。临床实践中会遇到不同的并发症，然而手术部位感染（SSI）似乎是最常见的。迄今为止，关于坦桑尼亚其他医院接受手术并转诊至穆希姆比利国家医院进行进一步治疗的患者术后并发症模式及与SSI相关因素的公开信息有限。因此，本研究的目的是确定研究参与者术后并发症的模式及与SSI相关的因素。
这是一项于2022年8月至2023年1月在穆希姆比利国家医院进行的基于医院的横断面研究，纳入了181名患者。使用频率表、Pearson卡方检验和二元逻辑回归模型对获得的数据进行分析，显著性水平为<0.05。
本研究纳入了181名患者，其中113名（62.4%）为女性；中位年龄为39岁。吸烟者和饮酒者分别为42名（23.2%）和90名（49.7%）。糖尿病患者有8名（4.4%），35名（19.3%）为HIV阳性，52名（28.7%）患有高血压。诊断与普通外科相关的患者占50.2%，而产科病例占30.9%。接受剖宫产的患者有45名（24.9%），而20名（11%）患者接受了全腹子宫切除术。肠切除及一期吻合术包括16名（8.8%）患者，穿孔性消化性溃疡修复术有8名（4.4%）患者。有感染性腹腔积液的患者有34名（18.8%），产后出血18名（9.9%）以及肠穿孔10名（5.5%）。作为治疗一部分接受再次剖腹手术的患者有70名（38.7%），而30名（16.6%）SSI患者通过连续伤口换药治疗，26名（14.4%）患者入住重症监护病房并接受护理。未发现任何因素与SSI有统计学显著关联。
胃肠病学和产科手术后有很大比例的患者出现术后并发症；在本研究中遇到的所有并发症中，SSI最为常见，占52%，其次是胃肠道并发症占31%。尽管有多个因素与SSI相关，但未发现其中任何一个因素具有统计学显著性。
