ArticleWorld journal of surgery2014
Inter-facility transfer of surgical emergencies in a developing country: effects on management and surgical outcomes.
Article in World journal of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effectiveness of different patient referral systems to shorten waiting times for elective surgeries: systematic review.BMC health services research · 2021Pooled it
- Patterns of facility and patient related factors to the orthopedic and trauma admissions at the Kenyatta National Hospital: A qualitative assessment.PLOS global public health · 2024Article
- Inter-hospital Transfer Delays to a Tertiary Referral Center and Postoperative Outcomes in Patients with Abdominal Surgical Emergencies in Malawi.World journal of surgery · 2022Article
- Predictors and management outcomes of perforated appendicitis in sub-Saharan African countries: A retrospective cohort study.Annals of medicine and surgery (2012) · 2022Article
- Assessment of Trauma Care Capacity in Karachi, Pakistan: Toward an Integrated Trauma Care System.World journal of surgery · 2021Article
- Logistical factors associated with adverse outcomes following emergency surgery in an acute care surgical unit.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Article
- Epidemiology and outcomes of trauma patients at The Indus Hospital, Karachi, Pakistan, 2017 - 2018.Pakistan journal of medical sciences · 2020Article
- Defining the Three Delays in Referral of Surgical Emergencies from District Hospitals to University Teaching Hospital of Kigali, Rwanda.World journal of surgery · 2019Article
- Global variation in anastomosis and end colostomy formation following left-sided colorectal resection.BJS open · 2019Observational
- Surgical referral systems in low- and middle-income countries: A review of the evidence.PloS one · 2019Review
- Consensus recommendations for essential vascular care in low- and middle-income countries.Journal of vascular surgery · 2016Article
- Epidemiology and Regional Distribution of Pediatric Unintentional Emergency Injury in Korea from 2010 to 2011.Journal of Korean medical science · 2015Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOutcomes of surgical emergencies are associated with promptness of the appropriate surgical intervention. However, delayed presentation of surgical patients is common in most developing countries. Delays commonly occur due to transfer of patients between facilities. The aim of the present study was to assess the effect of delays in treatment caused by inter-facility transfers of patients presenting with surgical emergencies as measured by objective and subjective parameters.
methodsWe prospectively collected data on all patients presenting with an acute surgical emergency at Aga Khan University Hospital (AKUH). Information regarding demographics, social class, reason and number of transfers, and distance traveled were collected. Patients were categorized into two groups, those transferred to AKUH from another facility (transferred) and direct arrivals (non-transfers). Differences between presenting physiological parameters, vital statistics, and management were tested between the two groups by the chi square and t tests.
resultsNinety-nine patients were included, 49 (49.5 %) patients having been transferred from another facility. The most common reason for transfer was "lack of satisfactory surgical care." There were significant differences in presenting pulse, oxygen saturation, respiratory rate, fluid for resuscitation, glasgow coma scale, and revised trauma score (all p values <0.001) between transferred and non-transferred patients. In 56 patients there was a further delay in admission, and the most common reason was bed availability, followed by financial constraints. Three patients were shifted out of the hospital due to lack of ventilator, and 14 patients left against medical advice due to financial limitations. One patient died.
conclusionsInter-facility transfer of patients with surgical emergencies is common. These patients arrive with deranged physiology which requires complex and prolonged hospital care. Patients who cannot afford treatment are most vulnerable to transfers and delays.
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