Rodríguez-Paz CA, González-de Blas JJ, Carreón-Bringas RM

Language: Spanish
References: 31
Page: 115-119
PDF size: 94.22 Kb.

ABSTRACT

Background: Worldwide, rural hospitals are a second level of health care for populations with ‹50,000 persons. On average, they perform 1000 surgical procedures with a mortality rate of 2%, assist in the transfer of patients (30-50%) and treat a wide variety of illnesses susceptible to surgical treatment depending on the prevalence of the disease in each community.
Our objective was to describe the analysis of the performed surgical procedures in a rural hospital in San Luis Potosi, México.
Methods: This was a retrospective, observational, descriptive and transversal study. We collected data from the clinical files of all surgical patients of the General Surgery, Obstetric/Gynecology and Orthopedics Departments from January 1 to December 31, 2007, analyzing mean age, number of surgeries, types of illness, morbidity and mortality.
Results: Of the 5544 discharges, there were 1508 surgical patients (27.2%) with an 80% female predominance and obstetric patients (57%). Mean age of the patients was 44.8 years. There were 86 different procedures performed. The most frequent procedures were total bilateral oophorectomy (36%), cesarean section (17%), inguinal hernia repair (6%), and cholecystectomy (4%), among others. From all the procedures, 51% were ambulatory, 11% trauma and 6% pediatrics. Morbidity was 0.76%, mortality 1.1% and the transferred patients represented 8.9%.
Conclusions: Outcomes of the rural hospital exceed the expectations of a second-level of health care and include participation of the trauma and pediatric surgery departments, with 86 different surgical treatments performed.

REFERENCES

1. Sariego J. Patterns of surgical practice in a small rural hospital. J Am Coll Surg 1999;189:8-10.

2. Van Bibber M, Zuckerman RS, Finlayson SRG. Rural versus urban inpatient case-mix differences in the US. J Am Coll Surg 2006;203:812-816.

3. Heneghan SJ, Bordley IVJ, Dietz PA, Gold MS, Junkins PL, Zuckerman RJ. Comparison of urban and rural general surgeons: motivations for practice location, practice patterns, and education requirements. J Am Coll Surg 2005; 201:732-736.

4. Stevermer JJ, Supattanasiri GJ, Williamson H. A survey of general surgeons in rural Missouri: potential for rapid decrease in work force. J Rural Health 2001;17:59-62.

5. Kumate RJ, Soberón G. Salud para todos ¿Utopía o realidad? México: El Colegio Nacional; 1989. pp. 90-91.

6. Carreón-Bringas RM, Rodríguez-Paz CA. Características epidemiológicas de trauma en el medio rural de la huasteca potosina. Cir Gen 2005;27:109-113.

7. Shively EH, Shively SA. Threats to rural surgery. Am J Surg 2005;190:200-205.

8. Thompson MJ, Lynge DCh, Larson EH, Tachawachira P, Hart LG. Characterizing the general surgeon workforce in rural America. Arch Surg 2005;140:74-79.

9. Oddone BN. Problems in rural surgery in Uruguay. World J Surg 2006;30: 1634-1635.

10. Mehendale V. Rural surgery in India. World J Surg 2007;31:1898-1899.

11. Symmons D, Curry C. Rural hospital generalist and emergency medicine training in Papua New Guinea. Emerg Med Australas 2007;19:151-154.

12. Ruiz-Sierra F. Experiencia quirúrgica en un hospital de distrito en Ruanda, África Central. Edu Invest Clin 2000;1:59-66.

13. Ameh EA, Chirdan LB. Paediatric surgery in the rural setting: prospect and feasibility. West Afr J Med 2001;20:52-55.

14. Padrón-Arredondo G. Procedimientos quirúrgicos generales en un hospital integral de Quintana Roo. Cir Cir 2006;74:115-120.

15. Rodríguez-Paz CA, Carreón-Bringas RM. Causas de intervención quirúrgica en un hospital rural de San Luis Potosí. Cir Gen 2001;23(supl 1):S52-S53.

16. Ameh EA. Surgery in a rural hospital: experience from northern Nigeria. East Afr Med J 1998;75:180-183.

17. Fernández-Cantón S. El IMSS en cifras: las intervenciones quirúrgicas. Rev Med IMSS 2003;43:511-520.

18. Instituto Mexicano del Seguro Social. El IMSS: compromiso de vanguardia. México: Fondo de Cultura Económica; 2006. pp. 362-366.

19. Nordberg E, Mwobobia I, Muniu E. Major and minor surgery output at district level in Kenya: review and issues in need of further research. Afr J Health Sci 2002;9:17-25.

20. Rodríguez-Paz CA, Carreón-Bringas RM. Experiencia del cirujano general en cesáreas en un hospital rural. Cir Gen 2004;26(supl 1):S49-S50.

21. Rodríguez-Paz CA, González-de Blas JJ, Carreón-Bringas RM. Experiencia en trauma de bazo en hospitales rurales. Trauma 2006;9:70-74.

22. Rodríguez-Paz CA. González-de Blas JJ, Carreón-Bringas RM. Experiencia en vasectomías y oclusión tubaria bilateral en dos hospitales rurales por cirugía ambulatoria. Cir Cir 2008;76:415-418.

23. Bintz M, Cogbill TH, Bacon J. Rural trauma care: role of the general surgeon. J Trauma 1996;41:462-464.

24. Mock CH, Arreola-Rissa C, Romero HE, de Boer M, Lomand JD. Fortalecimiento de la atención del trauma en México y a nivel mundial: Proyecto Atención Esencial en Trauma. Trauma 2004;7:5-14.

25. Sariego J. CCATT: a military model for civilian disaster management. Disaster Manag Response 2006;4:114-117.

26. García NLM, Padilla SR, Contreras EME, De la Fuente SS. Experiencia en trauma abdominal de naturaleza rural en Penjamo: la perspectiva de un centro regional sin sistema de trauma. Cir Gen 2007;29(supl 1):S99-S100.

27. Tulloh B, Clifforth S, Miller I. Caseload in rural general surgical practice and implications for training. ANZ J Surg 2001;71:215-217.

28. Bruening MH, Maddern GJ. The provision of general surgical services in rural South Australia: a new model for rural surgery. ANZ J Surg 1998;68:764-768.

29. Stewart GD, Long G, Tulloh BR. Surgical service centralization in Australia versus choice and quality of life for rural patients. Med J Aust 2006;185:162-163.

30. Landercasper J, Bintz M, Cogbill TH, Bierman SL, Buan RR, Callaghan JP, et al. Spectrum of general surgery in rural America. Arch Surg 1997;132:494-496.

31. Williamson HA, Hart LG, Pirani MJ, Rosenblatt RA. Market shares for rural inpatient surgical services: where does the buck stop. J Rural Health 1994;10:70-79.