ASSESSMENT OF PATTERN, OUTCOME AND ASSOCIATED FACTORS OF NON TRAUMATIC ACUTE ABDOMEN IN EMERGENCY DEPARTMENT, ST. PAUL`S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA

Abstract

Abstract Background: Acute abdomen is a major surgical problem in Ethiopia, requiring prompt diagnosis and surgery. This study aimed to assess the patterns, outcomes, and associated factors of non traumatic acute abdomen in the Emergency Department of St. Paul's Hospital in Addis Ababa, Ethiopia, during 2022. Objective: The objective of this study was to assess pattern, outcome and associated factors of non-traumatic acute abdomen in emergency department, St. Paul`s Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2022, Addis Ababa, Ethiopia. Methods: Hospital based one-year retrospective cross-sectional study done on 356 participants (Jan 1 - Dec 30, 2022) extracted secondary data from adult non-traumatic acute abdomen patient records. Simple random sampling finalized the participants. Epi-Info v7 cleaned and SPSS v25 analyzed the data, including descriptive statistics. Goodness-of-fit was assessed with the Hosmer and Lemeshow test (p=0.272). Logistic regression explored the association (p≤0.05, 95% CI) between independent variables and acute abdomen management outcome, leading to the final interpretation and report. Result: The study investigated 356 patients presenting with acute abdomen at St. Paul Hospital, Addis Ababa, Ethiopia. The most prevalent diagnoses were Acute appendicitis 46 (12.9%), perforated PUD 41 (11.5%), and Intestinal obstruction 33 (9.2%). Surgical management was implemented in 256 (72%) of cases, with an average length of stay of 3.8 days (range: 2-6 days). Post-operative complications were observed in 103 (28.9%) of patients, with intra-abdominal abscesses 37 (10.4%), surgical site infections 36 (10.7%), and wound dehiscence 30 (8.4%) being the most frequent occurrences. Notably, the mortality rate associated with acute abdomen was 53 per 1,000 patients, with a significant association observed between this outcome and various factors, including elevated heart rate (P = 0.047, AOR = 0.000, 95% CI = 9.529E-04 - 0.914), specific abdominal disorders Acute Cholecystitis (P = 0.000, AOR = 57.025, 95% CI = 37.475 - 62.135), Acute Appendicitis (P = 0.000, AOR = 26.001, 95% CI = 7.03 - 30.54), perforated PUD (P = 0.000, AOR = 77.605, 95% CI = 44.36 - 85.03), SBO (P = 0.000, AOR = 33.398, 95% CI = 29.058, 55.08) and post operative complications. Conclusion: Our study at St. Paul Hospital reveals both global echoes and Ethiopian nuances in managing acute abdomen. While sharing common presentations and surgical proficiency with international settings, the slightly higher complication and mortality rates call for tailored interventions and resource allocation specific to the Ethiopian context. By embracing both global practices and regional needs, we can optimize care for acute abdomen patients in Ethiopia. Key words: Acute abdomen ; Acute Appendicitis ; Perforated PUD Intestinal obstruction, ETHIOPIA .