Surgical morbidity and mortality pattern in the accident and emergency room--a preliminary report

Abstract

Background and purpose: A prospective review of surgical patients attending the Accident and Emergency room was carried out to determine the pattern of morbidity and mortality in order to guide planning and provision of surgical services and improve on the quality of care available.

Methods: Patients were entered into a data sheet from September 1999; a preliminary report of the first six months is presented.

Results: There were 1,209 patients (850 males and 359 females, M:F = 2.2:1) with 46 different presentations. Age range was 2 weeks to 95 years. The mode and median age was in the third decade. Morbidity from trauma was 70.5%, 44.5% from Road Traffic Accident while mortality from trauma was 2.6% (32 patients). Nearly half of the mortality (47.2%) was head injury related.

Conclusion: The commonest presentation was lacerations (19.4%) from which there was no mortality while head injury, multiple injury and multiple fractures that accounted for 14.7% morbidity had 61.1% mortality. These figures are helpful in planning services delivery and in focusing and improving on the mortality-prone presentations.