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识别模式:白沙瓦一家三级护理医院中创伤和外科急诊的患病率及管理

Identifying the Patterns: Prevalence and Management of Trauma and Surgical Emergencies in a Tertiary Care Hospital in Peshawar.

作者信息

Raheel Muhammad, Ullah Hameed, Haseeb Abdul, Moeed Muhammad, Ali Fawad, Wahid Uzma, Shah Sofia, Alizai Qaidar

机构信息

Department of Urology, Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar, PAK.

Department of Surgery, Hayatabad Medical Complex, Peshawar, PAK.

出版信息

Cureus. 2025 Jun 20;17(6):e86462. doi: 10.7759/cureus.86462. eCollection 2025 Jun.

DOI:10.7759/cureus.86462
PMID:40693086
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12277483/
Abstract

Introduction Surgical emergencies are considered a significant part of the overall healthcare burden that usually require timely evaluation and urgent intervention to prevent complications and mortalities. The surgical emergency room (SER) is part of the accident and emergency bay that provides care to patients presenting with acute injuries and non-traumatic surgical complaints. The objective of our study was to investigate the patterns of all diseases presenting to the SER and the differences in treatment and outcomes of patients based on trauma vs. non-trauma complaints. Methods We performed a prospective descriptive study at the SER from March 1, 2023, to March 15, 2023. Patients of all ages and either gender presenting to the SER with any complaint during the data collection period were included. Patients were stratified into two groups: Group T (trauma) and Group NT (non-trauma). These groups were compared for baseline characteristics and outcomes. Descriptive statistics were used to summarize the findings. Analyses were conducted to compare trauma vs. non-trauma patients in terms of baseline characteristics, management, and outcomes. A p-value less than 0.05 was considered statistically significant. Results A total of 550 patients were analyzed, with 97 (17.6%) in Group T and 453 (82.4%) in Group NT. The mean ± SD age was 31.1 ± 17.7 years, with a male predominance (n = 352, 64.0%). Abdominal pain was the most common presentation (n = 172, 31.3%), followed by trauma (n = 97, 17.6%). There was no statistically significant difference in baseline characteristics and comorbid conditions between trauma and non-trauma patients (p > 0.05). However, trauma patients more frequently received intravenous (IV) analgesics (T: 75 [77.3%] vs. NT: 135 [29.8%], p < 0.001) and IV fluids (T: 78 [80.4%] vs. NT: 107 [23.6%], p < 0.001). Non-trauma patients received more IV antibiotics (T: 20 [20.6%] vs. NT: 155 [34.2%], p = 0.012) and oral analgesics (T: 45 [46.4%] vs. NT: 280 [61.8%], p = 0.004). Critical interventions were more frequent in the trauma group, including chest intubation (T: 5 [5.2%] vs. NT: 0, p < 0.001) and endotracheal intubation (T: 7 [7.2%] vs. NT: 2 [0.4%], p < 0.001). There was no significant difference in the rates of major surgeries (p > 0.05). ICU admissions (T: 25 [25.8%] vs. NT: 10 [2.2%], p < 0.001) and mortality (T: 4 [4.1%] vs. NT: 1 [0.2%], p = 0.003) were higher among trauma patients. Conclusion This study offers a detailed overview of surgical emergencies in a tertiary care hospital in Pakistan, highlighting patterns that both mirror and differ from international data. Beyond the description of disease presentations, we compare the management strategies and outcomes of patients based on trauma-related versus non-trauma complaints. Our findings may serve as a reference for future research and development of treatment guidelines for surgical emergencies.

摘要

引言

外科急症被认为是整体医疗负担的重要组成部分,通常需要及时评估和紧急干预以预防并发症和死亡。外科急诊室(SER)是急诊区的一部分,为出现急性损伤和非创伤性外科病症的患者提供护理。我们研究的目的是调查在SER就诊的所有疾病模式以及基于创伤与非创伤病症的患者在治疗和结局方面的差异。

方法

我们于2023年3月1日至2023年3月15日在SER进行了一项前瞻性描述性研究。纳入在数据收集期间因任何病症就诊于SER的所有年龄和性别的患者。患者被分为两组:T组(创伤组)和NT组(非创伤组)。比较这两组的基线特征和结局。使用描述性统计来总结研究结果。进行分析以比较创伤组与非创伤组患者在基线特征、管理和结局方面的差异。p值小于0.05被认为具有统计学意义。

结果

共分析了550例患者,其中T组97例(17.6%),NT组453例(82.4%)。平均±标准差年龄为31.1±17.7岁,男性占优势(n = 352,64.0%)。腹痛是最常见的症状(n = 172,31.3%),其次是创伤(n = 97,17.6%)。创伤组和非创伤组患者在基线特征和合并症方面无统计学显著差异(p > 0.05)。然而,创伤患者更频繁地接受静脉(IV)镇痛药(T组:75例[77.3%] vs. NT组:135例[29.8%],p < 0.001)和静脉输液(T组:78例[80.4%] vs. NT组:107例[23.6%],p < 0.001)。非创伤患者接受更多的静脉抗生素(T组:20例[20.6%] vs. NT组:155例[34.2%],p = 0.012)和口服镇痛药(T组:45例[46.4%] vs. NT组:2\80例[61.8%],p = 0.004)。创伤组的关键干预更频繁,包括胸部插管(T组:5例[5.2%] vs. NT组:0例,p < 0.001)和气管插管(T组:7例[7.2%] vs. NT组:2例[0.4%],p < 0.001)。大手术率无显著差异(p > 0.05)。创伤患者的重症监护病房(ICU)入住率(T组:25例[25.8%] vs. NT组:10例[2.2%],p < 0.001)和死亡率(T组:4例[4.1%] vs. NT组:1例[0.2%],p = 0.003)更高。

结论

本研究详细概述了巴基斯坦一家三级医院的外科急症情况,突出了与国际数据既相似又不同的模式。除了对疾病表现的描述外,我们还比较了基于创伤相关与非创伤病症的患者管理策略和结局。我们的研究结果可为未来外科急症治疗指南的研究和制定提供参考。

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