Prevalence, associated factors and in-hospital outcomes of gastrointestinal perforations at Bwera General Hospital, Kasese - Uganda: a retrospective cross-sectional study

Abstract

Introduction: Gastrointestinal perforations (GIPs) constitute surgical emergencies which necessitate prompt diagnosis and management that is significantly facilitated by the availability of adequate facilities and resources. Knowledge of prevalence, associated factors and in-hospital outcomes of mortality, Enterocutaneous fistulas and reoperations is crucial for ensuring optimal resource availability, allocation and improved patient care. However, in rural areas of sub–Saharan Africa including Uganda, there is paucity of research on prevalence, associated factors and outcomes of GIPs.

Objective: To determine the prevalence, associated factors and outcomes of GIPs at Bwera General Hospital, Kasese, Uganda.

Methods: A hospital based cross sectional study involving review of patient charts (from 1st Jan 2019 to 30th Dec 2023) was conducted at Bwera General Hospital in Kasese district. Stata version 18 was used to analyze data and descriptive statistics were reported using mean (SD) and frequency (proportion) for continuous variables and categorical variables respectively. Modified Poisson regression analysis for factors associated with GIPs was done.

Results: Among the 870 patients with GIT conditions 143 were found to have been diagnosed with GIPs. A prevalence of GIPs of 16.6% 95% CI (14.2% to 19.2%) was thus reported with in hospital deaths of 8.5% 95% CI (4.8% - 14.4%) and 5.7% 95%CI (2.8% -11.0%) of these participants staying long in the hospital (>2 weeks). Age AOR 0.978 95%CI (0.966-0.991), having typhoid AOR 2.147 95%CI (1.332-3.460), and were the factors associated with having a GIP.

Conclusion: There is a high burden of GIPs, in hospital mortality and short hospital stays in Bwera hospital. Notably Younger age, having a history of typhoid, PUD and GIT tumors were associated with an increased risk of GIPs in Bwera General Hospital.