Negative components of diagnostic and treatment tactics in patients with acute surgical diseases of the abdominal cavity with fatal consequences

June 6, 2022
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The article presents the results of the analysis of staged diagnosis and treatment of 422 patients with acute surgical diseases of the abdominal cavity with a fatal outcome. The structure of the root causes that led to death was: gastrointestinal bleeding in 173 (41%), peritonitis in 72 (17.6%), acute vascular diseases of the intestine in 51 (12.09%), complications of gastrointestinal cancer in 30 (7.11%) patients; elderly and senile patients were dominated (223; 52.84%) and mostly men (225; 53.32%). Analysis of the period of hospitalization from the moment of the disease to the medical hospital showed that 287 (68.1%) patients were hospitalized 1 day after the disease, according to the degree of operative-anesthesiological risk according to the scale of the American Society of Anesthesiologists every 3rd (107; 38.63%) patient was III and IV degree, and the term of arrival of the ambulance to 176 (41.71%) patients was in the period from 10 minutes to 1 hour, to 191 (45.26%) patients — exceeded 1 hour. In the city of Kyiv in 2021, emergency medical care was provided by understaffed doctors at the pre-hospital stage by 29.7%, at the hospital stage — 34.78%, and the replacement of doctors at the pre-hospital stage by paramedics led to comprehensive antishock therapy only in 9 (4.35%) of 207 patients.

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