Master Dissertations

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Browsing Master Dissertations by Subject "Abdominal surgery"

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    Prevalence, patterns and factors associated with management outcomes of enterocutaneous fistula patients at the University of Dodoma affiliated teaching hospitals
    (The University of Dodoma, 2023) Masiaga, Nicholaus Mrimi
    Background: Enterocutaneous fistula (ECF) remains a significant challenge encountered by surgeons following abdominal surgeries, with reports highlighting heightened mortality rate 30%. A comprehensive understanding of ECF by health professionals is required to empower them to make informed decisions during devising personalized treatment plans, reducing treatment delays, and enhancing patient quality of life. This study aimed at assessing the prevalence, patterns, and management outcomes of enterocutaneous fistula. Methodology: This was a prospective longitudinal analytical study done at the University of Dodoma-affiliated teaching hospitals. A total of 60 patients with ECF were enrolled using a convenient sampling approach. The data were collected through face-to-face interviews; from patient files and laboratory records. Analysis was done using IBM SPSS version 26. The study utilized both univariate and multivariate binary logistic regression analyses to identify predictors of outcomes. A p value < 0.05 was regarded as statistically significant. Results: This study enrolled 60 patients with the mean age of 40.3 ± 14.5 years, ranging from 13 to 68 years. Over one-third of the participants were in the age group of 45 years and above and 33 (55%) were female. Out of 6655 patients who were admitted in surgical ward, 3132 had history of abdominal surgery; of which 59 developed ECF that accounted for an overall prevalence of 1.9%. Most of the patients (68.3%), had unsuccessful fistula closure while 31.7%, had successful fistula closure, mean duration of successful closure was 27.7±9.4 days. Majority (73.3%) of patients stayed in the ward for more than 28 days. Case fatality rate was 30%. Multivariate logistic regression analysis identified small bowel ECF (AOR: 18 95% CI: 1.311- 260.3), anemia of Hemoglobin less than 11g/dL (AOR: 6, 95% CI: 1.115-32.42) and age more than 45 years (AOR: 24, 95% CI: 1.268-457.5) as independent predictors of unfavorable outcomes. Conclusion: Enterocutaneous fistula is a known complication to the patients who undergo abdominal surgery with prevalence of 1.9% and had high mortality rate of 30%. High output ECF, elderly and anemia are the predictors of unfavorable outcomes.