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Main arrow Archive of previous Issues arrow ╣3 2011 (19) arrow Reasons for lethal outcomes of digestive organ diseases in surgical hospitals in the Russian Federation, the north Caucasian federal district, and Stavropol territory in dynamics for 10 years
Reasons for lethal outcomes of digestive organ diseases in surgical hospitals in the Russian Federation, the north Caucasian federal district, and Stavropol territory in dynamics for 10 years Print
Friday, 30 September 2011

Summary. During the last years, an increase in the number of surgical operations and a rise of surgical activity are observed in hospitals in the Russian Federation. Urgent conditions in abdominal organ diseases are extensional and non-homogeneous that is evidenced in a large number of special literature. This group incorporates diseases different in etiology and pathogenesis, but all of them obligatory threaten patientsĺ life and require urgent interventions including surgical ones. It is natural that scientific interests appeal to not only an assessment of outcomes of emergency care provided but also to the causes of mortality after treating this pathology. The particular targets of the present study were the reasons of lethal cases. To provide the study, the analysis of lethal outcomes in patients with digestive organ diseases was carried out in dynamics in hospitals of the Russian Federation, the North Caucasian Federal District, and Stavropol territory. Data for the analysis have been taken from the corresponding forms of the Federal Statistical Supervision across the Russian Federation, Stavropol territory and Stavropol-city for 2001-2010, and the North Caucasian Federal District for 2006-2010.

From 2001 to 2010, the comparative analysis of disease dynamics was carried out in the territories of the Russian Federation and Stavropol territory separately.

The total number of patients died during 10 years in surgical hospitals in Russia was 46837, in Stavropol territory - 771. Among the reasons of lethal outcomes in the operated and not operated patients, the following reasons were registered most often in surgical hospitals of the Russian Federation: perforating gastric and duodenal ulcers (8,2 %), acute ileac passion (5,1 %), gastroenteric bleedings (5,3 %). Patientsĺ lethal cases caused by entrapment of a hernia (3.2 %) and acute pancreatitis (3,5 %) are less often. Lethal outcomes caused by those diseases were lower in Stavropol territory than in Russia. The research provided in dynamics for 10 years has revealed no essential positive tendency in mortality caused by digestive organ diseases in the Russian Federation. Moreover, there was registered a growth in mortality caused by perforating gastric and duodenal ulcers by 2,1 %, gastroenteric bleedings by 2,3 %, and acute pancreatitis by 27,5 %. In Stavropol territory mortality caused by perforating gastric and duodenal ulcers has decreased by 24,3 %, the number of gastroenteric bleeding cases has decreased in 2 times. The defining factor for outcomes of treating diseases, which require emergency surgical care, is the term of patientĺs delivery to a hospital.

With delivery to a surgical hospital later than 24 hours after acute condition (gastric ulcer perforation, gastroenteric bleeding), the probability of a lethal outcome increases in 2,1 - 7,5 times.

Comparison between the data obtained and the probability calculated for patients delivered to a hospital with the diagnosis of perforating gastric and duodenal ulcers shows that the probability of lethal outcome is 41,8 % (i.e. almost half died) if a patient is delivered to a hospital during the first day of disease, i.e., the earlier patient is delivered to a hospital the more favorably is an outcome. It is important to note that medical errors in 80-85 % of cases are also the reasons of disease complications, which often lead to heavy clinical outcomes. Thus, monitoring of quality of medical care together with a work to prevent medical errors should take the central place in health care process.

Keywords. Reasons for lethal outcomes, digestive organ diseases, surgical hospitals, urgent conditions.

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