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World Journal of Surgery

, Volume 41, Issue 2, pp 370–379 | Cite as

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

  • G. Tumusiime
  • A. Was
  • M. A. Preston
  • J. N. Riesel
  • S. S. Ttendo
  • P. G. Firth
Original Scientific Report with Video

Abstract

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 < 0.001) than patients recorded in the logbbook; there was no diffence in gender (male 62.8 % versus 67.0 %, p = 0.20).

Conclusions

The hospital records system measures surgical care, but improved data capture is needed to determine outcomes with sufficient accuracy to guide and record expansion of surgical capacity.

Keywords

Operative Care Medical Record Number Congenital Condition Regional Referral Hospital Senior House Officer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We wish to thank Manfred Amanya for electronic data entry and Nicholas Musinguzi, Trudy Poon and Hao Deng for statistical analysis.

Funding

This project was supported by funding from MGH Global Health, Massachusetts General Hospital, Boston, MA, USA.

Compliance with ethical standards

Conflicts of interest

We declare that we have no conflicts of interest.

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • G. Tumusiime
    • 1
  • A. Was
    • 2
  • M. A. Preston
    • 3
    • 4
  • J. N. Riesel
    • 4
    • 5
  • S. S. Ttendo
    • 6
  • P. G. Firth
    • 4
    • 7
  1. 1.Department of SurgeryMbarara University of Science and Technology, Mbarara Regional Referral HospitalMbararaUganda
  2. 2.Department of PediatricsLucile Packard Children’s Hospital at StanfordPalo AltoUSA
  3. 3.Department of SurgeryBrigham and Woman’s HospitalBostonUSA
  4. 4.Program for Global Surgery and Social ChangeHarvard Medical SchoolBostonUSA
  5. 5.Department of SurgeryMassachusetts Geenral HospitalBostonUSA
  6. 6.Department of Anaesthesia and Critical Care, Mbarara University of Science and TechnologyMbarara Regional Referral HospitalMbararaUganda
  7. 7.Department of Anesthesia, Critical Care and Pain MedicineMasachusetts General HospitalBostonUSA

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