A 25-year study of emergency surgical admissions

Abstract

Background: Numbers of emergencies are increasing, but no comprehensive data are available for emergency surgical admissions. This study documents the changes over 25 years in a district general hospital.

Methods: Details of all general surgical (including urological) emergency admissions were analysed for every fourth calendar year from 1974 to 1998.

Results: A total of 19,931 patients were admitted during the 7 years studied, rising from 2137 in 1974 to 3578 in 1994 (3377 in 1998). Mean age increased from 47.9 years to 52.6 years while mean length of stay fell from 9.5 days to 5.3 days. Hospital mortality decreased from 6.6% to 3.7%. When calculated per 100,000 population, the increase in admission rate was significant (P < 0.001) but bed requirements did not increase despite the increase in workload. Several diagnoses became significantly more frequent (ruptured aortic aneurysm, gallstones, constipation, cutaneous abscess, diverticular disease, gastroenteritis, non-specific abdominal pain, pilonidal sinus and urinary diagnoses). Appendicitis and non-malignant intestinal obstruction became significantly less common.

Conclusions: This study has documented a progressive increase in surgical admissions. Despite increasing age of patients, lengths of stay and hospital mortality have decreased.