Cirugía general de emergencia en Perú: Un estudio multicéntrico prospectivo

Abstract

Background: Emergency surgery is a global public health issue due to the burden of years of life lost. Peru still lacks a formal epidemiological registry of emergency surgical pathologies, as well as a national report on postoperative mortality rates. In response to this, the Peruvian Society of General Surgeons presents this research to describe our national reality in emergency surgeries. Methodology: This is a prospective, multicenter observational cohort study carried out from October 2022 to January 2023 in hospitals across Peru. The aim was to determine the incidence of the most frequent emergency surgical pathologies, describe the affected population and their perioperative outcomes (morbidity and mortality), as well as to describe the institutions responsible for patient management. Results: Data was obtained from
1351 patients treated in 24 participating hospitals. The most frequent pathology was inflammatory, with acute appendicitis being the leading cause of emergency surgery (646 cases). Ultrasound was used for diagnosis in 99% of cases, with only 25% using tomography. The World Health Organization (WHO) surgical safety checklist was applied
in 95% of cases. Laparoscopy was employed in 45% of surgical interventions. One in three patients experienced some form of postoperative complication. Re-interventions occurred in 4.8% of cases, and the reported mortality rate was
3.9%. Conclusions: The main cause of emergency surgeries is inflammatory pathology. The high adherence of the WHO surgical safety checklist reflects a commitment to patient safety. The use of laparoscopic surgery should be optimized in
public sector hospitals. The reported mortality rate in emergency surgery was similar to that of countries with a high Human Development Index.