ANALYSIS OF THE PROVISION OF EMERGENCY SURGICAL CARE IN THE REPUBLIC OF NORTH OSSETIA-ALANIA FOR 2021-2023

Abstract

Background. Emergency abdominal surgical pathology accounts for a significant proportion of hospital deaths. The most common emergency abdominal conditions include acute appendicitis, intestinal obstruction, perforated gastric and duodenal ulcers, gastrointestinal bleeding, strangulated hernias, acute cholecystitis, and acute pancreatitis. Regular analysis of emergency department data is essential to identify any problems that exist and develop strategies for addressing them.

Purpose. To analyze the performance of the RSO-Alania surgical service in treating the most common emergency conditions of the abdominal cavity over the period from 2021 to 2023. We aim to identify key trends and challenges, as well as possible solutions.

Materials and methods. The data for this analysis will be drawn from the annual electronic reports of medical organizations in the Republic of North Ossetia-Alania, which provide emergency surgical care for the adult population. We will examine the incidence, frequency of surgeries, and overall and postoperative mortality rates for seven major urgent surgical conditions: acute intestinal obstruction, acute appendicitis, perforated ulcers, gastrointestinal bleeding, strangulated hernias, acute cholecystitis, and acute pancreatitis.

Results. During the three-year period analyzed, there was an increase in hospital admissions for emergency patients of 59,9%, and an increase in surgical interventions of 86,2%. However, the percentage of delayed admissions remained high. There was an increase in admissions for all urgent conditions, except for ulcer bleeding, which saw a decrease. The overall mortality rate decreased from 1,6% in 2021 to 1,1% in 2023, although it was still lower than the national average. However, there were some exceptions, with mortality rates for perforated stomach and duodenal ulcer being comparable to the national average in 2022.

Conclusion. The analysis showed that the conversion of major republican hospitals at the third level into infectious disease hospitals (in 2020-2021) and the redirection of patient flow to district hospitals at the first level had a negative impact on the outcomes of emergency surgical treatment. To improve the outcomes for urgent surgical patients in North Ossetia-Alania, a three-tiered care system should be established, including the establishment of a staffed and equipped inter-district surgical center at the second level. Additionally, a clear patient referral system should be developed to concentrate the most complex patients in surgical facilities at the third level in Vladikavkaz.

EDN: NTWYCU