Trends in emergency surgical admissions in a tertiary health centre in Nigeria

In the past, elective surgery was the predominant in-patient workload of consultant surgeons. Recently, emergency cases are forming an increasing part of the in-patient workload.

The aim of this study was to appraise the rising incidence of emergency surgical admissions (EMA) as well as the factors associated with the change.

A retrospective review of surgical admissions in the Department of Surgery Ahmadu Bello University Teaching Hospital Zaria, Nigeria. Every third year from 1970 to 2000 was selected giving a total of 10 years for review. Details of all surgical admissions were analysed including age and sex of the patients, incidence of the most common primary diagnoses, proportion of patients having operation during their emergency admission, duration of hospital stay and mortality.

Overall, 19,436 emergency and 19,528 elective surgical admissions (ELA) were made. The ratio of EMA to ELA per 100,000 catchment's area population rose from 1:1.6 in 1973 to 1.4:1 in 2000. Between 1995 and 2000, the rise in EMA was 8.0% per year compared to 1.5% rise in ELA. About 30% of ELA were cancelled due to factors related to EMA. Rising incidence of appendicitis, acute infections and trauma accounted for most of the increase in EMA. Operations during EMA increased from 35.3% in 1973 to 45.0% in 2000. Postoperative mortality remained at about 6.0%

Emergency surgical admissions have increased and now exceed elective admissions. This has placed considerable strain on our limited resources and our ability to cope with increasing demand of elective surgery.