000			05596nam a22004097a 4500
001			CUHAS/MMED/6000343/T/19
003			CUHAS/MMED/6000343/T/19
005			20240429084033.0
008			221208b |||||||| |||| 00| 0 eng d
028			_bWurzburg Road 35, BMC Premises, Post Code: 33102:
028			_b P. O. Box 1464, Mwanza – Tanzania:
028			_bPhone: +255 28 298 3384:
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_b Website: www.bugando.ac.tz
035			_aCUHAS/MMED/6000343/T/19
040			_bEnglish _cddc
041			_aEnglish
100			_a Ruzige Christian _d[Male] _947109 _eCUHAS/MMED/6000343/T/19
210			_aLIST OF ABBREVIATIONS AND ACRONYMS _bAICU Adult Intensive Care Unit ASA America Society of Anaesthesia BMC Bugando Medical Centre BP Blood Pressure CUHAS Catholic University of Health and Allied Science EGS Emergency General Surgery EMD Emergency Medicine Department HDU High Dependency Unit ITTS Ideal Time to Surgery IQR Interquartile Range LMIC Lower and Middle-Income Countries LOS Length of Hospital Stay MO Medical Officer PR Pulse Rate RR Respiratory Rate SOPD Surgical Outpatient Department SPO2 Oxygen Saturation SSI Surgical Site Infection STATA South Texas Art Therapy Association TACS Timing of acute care surgery TEMP Temperature WSES World society of emergency surgery
222			_aOPERATIONAL DEFINITIONS _bReferred emergency general surgery patient – defined as any patient received from another facility requiring an emergency surgical evaluation and management (operative or non-operative) for diseases within the realm of general surgery at BMC. Disease conditions are summarized in Table 8.
222			_aOPERATIONAL DEFINITIONS _bShort-term treatment outcome –is termed as in-hospital mortality, length of hospital stay, and readmission in <30 days regarding index hospitalization.
222			_aOPERATIONAL DEFINITIONS _b30-day readmission; is defined as any unplanned, distinct hospitalization within 30 days after the discharge of the index hospitalization
222			_aOPERATIONAL DEFINITIONS _bIn-hospital mortality; is defined as the death due to any cause during the index hospitalization before discharge.
222			_aOPERATIONAL DEFINITIONS _bLength of stay; is defined as the interval between the date of the admission and the date of discharge.
222			_aOPERATIONAL DEFINITIONS _bSurgeon – is termed as a specialized surgery care provider
222			_aKey words: _b emergency general surgery, surgical care, referral system
245			_aPredictors and short term treatment outcomes among referred emergency general surgery patients admitted at Bugando Medical Centre, Mwanza, Tanzania
260			_aMwanza, Tanzania: _bCatholic University of Health and Allied Sciences [CUHAS – Bugando] : _c2023
300			_a105 Pages
300			_aIncludes References
520			_aAbstract: Background: The triad of referral delays encompassing seeking care, reaching care, and receiving care have been used to assess access to treatment both in medical and surgical care at different levels of care. However the effect of potential referral factors on the surgical treatment outcome of referred Emergency General Surgery patient admitted at BMC have not been determined, also the surgical treatment outcome of referred Emergency General Surgery patient admitted at the tertiary level hospital is insufficiently documented in Tanzania . This study was conducted to determine the factors associated with in-hospital mortality, readmission rate in 30days, and length of hospital stay among referred Emergency General Surgery patients admitted at Bugando Medical Centre a tertiary hospital in Tanzania. Methods: This was the longitudinal observational study conducted at Bugando Medical Centre involving admitted patients of all age groups referred from other facilities with emergency general surgery diagnoses from June 2021 to February 2022. Permission to conduct the study was obtained from Bugando Medical Centre/Catholic University of Health and Allied Science authorities with clearance certificate number CREC/482/2021. Results: A total of 280 referred emergency general surgery participants were enrolled into the study. 37.9% had more than 14 days of hospital stay with median of 10days (IQR=7-21), in hospital mortality was observed in 22.1 % and 30 days readmission was 10.7%.Length of hospital stay was significantly associated with direct surgical ward admission, general abdominal conditions and soft tissue conditions, surgical operation conducted more than 48hours of admission, duration of operation more than 2hours and more than one surgical operations at BMC. Mortality were significantly associated with age below 15 years and above 35years, Non insured patients, resuscitation status before admission at BMC, ambulance brought in patients and more than one surgical operation at a referring facility. 30 days readmission was significantly associated with age >35 years, comorbidity and operation status at referring facility. Conclusion: Referred emergency general surgery patients population is disadvantaged by having prolonged length of hospital stay, significant in hospital mortality and 30days hospital re-admission, surgical care offered at referring facility and receiving facility both predict overall treatment outcome at tertiary level hospitals in Tanzania.
600			_xSurgery _929082
700			_aWilliam Mahalu _915823
700			_aGeoffrey Giiti _945564
942			_2ddc _cMP
999			_c18567 _d18567