Complications Per and Post Operatory (CPPO) at the Gabriel Toure University Hospital in Bamako

Abstract

Introduction : Despite the use of less invasive and increasingly effective techniques in order to reduce the morbi-mortality per and post-operative, the CPPO remain an important problem in surgery. Objectives : To determine the rate of per and post-operative complications, to describe the types of complications and to identify their risk factors. Methodology : This was a prospective study carried out from 04 April to 03 June 2016 in the surgical department of CHU-Gabriel TOURE. All patients aged 18 and over operated in the Surgical Department (General Surgery, Gynaecology and Obstetrics, Urology, Traumatology, Otolaryngology, Neurosurgery and Emergency Department), having been hospitalized at least for 24 hours after surgery, were retained. The method of sampling N=P(1-P)Za 2 /I 2 was used; the minimum size necessary was 209 patients. We conducted invitations and the phone call to determine the occurrence of complications and survival of patients up to 30 days after surgery. Results : We counted 262 patients, of whom 142 (54.2%) were women and 120 (45.8%) were men with a sex ratio = 0.85. The average age was 41.48 years, with extremes of 18 and 86 years. We found 71 complications in 61 patients, an early CPPO rate of 23.28%. The various complications encountered were: urinary tract infections (26.76%), surgical site infections (28.17%), pulmonary infections (12.68%) and Deaths (21.13%). The occurrence of complications prolonged the hospital stay by 6 days and increased the average cost of care of 102,700 FCFA. According to Clavien Dindo’s classification, the severe postoperative complication in our series was 9.16% (grade III + IV + V). Factors favoring the occurrence of CPPO were age > 41 years old, ASA > II, the classes of Altemeier 3 and 4, NNISS score 1 and 2, diabetes and hemoglobin rate 8 g/dl. Conclusion : Complications per and post-operative (CPPO) are common in the department of Surgery of CHU-Gabriel TOURE and are dominated by post-operative infection. These complications seem to be favored by multiple factors more related to the patients than to the hospital structure.