Chamberlain Stacey, Ugwu-Dike Pearl, Mbiine Ronald, Sims Thomas, Rice Brian T
Global Emergency Care, Inc.
New York University, Department of Dermatology, New York, New York.
West J Emerg Med. 2025 Jul 12;26(4):994-1001. doi: 10.5811/westjem.24989.
Delivery of emergency surgical care remains a challenge in much of Sub-Saharan Africa, with physician shortages in Uganda resulting in only one surgeon per 100,000 people. Emergency units in Uganda receive emergency surgical patients, but it is unknown how great of a burden these emergency surgical patients represent in terms of total number, care required, or outcomes.
We performed a retrospective review of a quality assurance database for all patients treated at two emergency units in Uganda from 2009-2019. Patients were defined as "surgical" if they were admitted directly to the operating theatre, received a surgical diagnosis, or received an emergency surgical procedure as identified by the Disease Control Priorities 3 (DCP3) group. We generated descriptive statistics.
Of the 109,999 total patients seen, 24,745 (22.5%) were emergency surgical patients. Surgical patients were predominantly male (71.7%) with a mean age of 34.9 years. Most surgical patients (57.0%) were admitted to the hospital, while 38.9% were discharged, and only 1.7% were sent directly to the operating theatre. In total, 12.1% of all patients seen in the emergency unit received a surgical procedure from a non-physician clinician while in the unit. Of the surgical procedures, the most common were suturing of lacerations (51.8%), urinary catheterization (24.5%), fracture management (16.5%), and incision and drainage of abscesses (6.0%). Among surgical patients, the most common surgical diagnoses were for fractures (30.9%), lacerations (29.6%), and abscesses (8.8%). The overall three-day mortality for emergency surgical patients was 2.8%.
Emergency surgical patients are common in Ugandan emergency units, where emergent surgical procedures are commonly performed by non-physician clinicians. Strengthening system capacity for emergency surgical patients should also consider emergency unit resources.
在撒哈拉以南非洲的大部分地区，提供急诊外科护理仍然是一项挑战，乌干达的医生短缺导致每10万人中仅有一名外科医生。乌干达的急诊科接收急诊外科患者，但这些急诊外科患者在总数、所需护理或治疗结果方面所代表的负担程度尚不清楚。
我们对2009年至2019年在乌干达两个急诊科接受治疗的所有患者的质量保证数据库进行了回顾性分析。如果患者直接被送入手术室、接受手术诊断或接受疾病控制优先事项3（DCP3）小组确定的急诊外科手术，则被定义为“外科患者”。我们生成了描述性统计数据。
在总共109999名就诊患者中，24745名（22.5%）为急诊外科患者。外科患者以男性为主（71.7%），平均年龄为34.9岁。大多数外科患者（57.0%）住院，38.9%出院，只有1.7%直接被送入手术室。在急诊科就诊的所有患者中，总计12.1%在该科室接受了非医师临床医生进行的外科手术。在外科手术中，最常见的是伤口缝合（51.8%）、导尿（24.5%）、骨折处理（16.5%）和脓肿切开引流（6.0%）。在外科患者中，最常见的外科诊断是骨折（30.9%）、伤口（29.6%）和脓肿（8.8%）。急诊外科患者的总体三日死亡率为2.8%。
急诊外科患者在乌干达急诊科很常见，急诊外科手术通常由非医师临床医生进行。加强急诊外科患者的系统能力也应考虑急诊科资源。
