Emergency general surgical admissions. Prospective institutional experience in non-traumatic acute abdomen: implications for education, training and service.

OBJECTIVE To assess the pattern of non-traumatic acute abdomen (NTAA) in emergency general surgical admissions in Saudi Arabia (SA) and highlight the implications for education, training and patient care. METHODS A prospective study including all emergency general surgical admissions with NTAA at King Fahd Hospital of the University, Al-Khobar, SA over a 2-year period from October 2001 to September 2003. RESULTS There were 3,706 general surgical admissions; 1,661 (45%) electives and 2,045 (55%) emergencies. A total of 1,096 admissions (mean age 27.6 years, 73% males) with NTAA were analyzed. Acute appendicitis was the most common diagnosis (47%), followed by non-specific abdominal pain (19%), gallstone disease (11%) and intestinal obstruction (8%). Surgical intervention was indicated in 65% of the admissions; 77% of these had appendectomy. There were 35 patients (3%) with malignancy, and 12 hospital deaths (1%). The mean length of hospital stay (LOS) was 6.6 days. The LOS increased significantly with age. CONCLUSION In our setting, NTAA was the most common cause for general surgical admissions, accounting for 30% and 54% of the total surgical and emergency surgical admissions respectively. Most of the patients were young and acute appendicitis was the most common diagnosis. Further National/regional multicenter studies are needed to assess the trend of emergency surgical admissions and their impact on surgical practice, overall health care costs, medical education and training in SA.