Determinants of decision-to-intervention time in the management and therapeutic outcome of emergency gynecological surgeries in south east Nigeria

Figures & data

Table 1 Sociodemographic characteristics of participants

Variables	N (%)
Age (years)
≤20	12 (11.4)
21–25	67 (63.8)
26–30	23 (21.9)
31–35	3 (2.9)
Marital status
Married	29 (27.6)
Single	75 (71.4)
Separated	1 (1.0)
Educational status
None	8 (7.6)
Primary	20 (19.1)
Secondary	67 (63.8)
Tertiary	10 (9.5)
Employment status
Employed	24 (22.9)
Unemployed	81 (77.1)
Residence
Urban	32 (30.5)
Rural	73 (69.5)
Parity
0	64 (61.0)
1–4	41 (39.0)

Notes: N=105. Urban residence: high density population located in large cities with modern infrastructures. Rural residence: low density population located in smaller towns, villages and hamlets with little or no social infrastructures.

Table 2 Emergency gynecological surgeries and their indications, N=105*

Variables	N (%)
Exploratory laparotomy, N=105 (indications)
Ruptured ectopic pregnancy	62 (59.0)
Ovarian cyst (complicated; rupture and torsion)	30 (28.6)
Perforated uterus from unsafe abortion	6 (5.7)
Pelvic abscess	5 (4.8)
Ovarian abscess	2 (1.9)

Note:

* Emergency gynecological surgeries and their indications listed once.

Table 3 Major reasons for delay >60 minutes from DIT*

Variables	N (%)
Reasons
Nonavailability of blood/blood products	49 (46.7)
Delay in administration of anesthesia	4 (3.8)
Nonavailability of medications, surgical materials	12 (11.4)
Nonavailability/inadequacy of care providers	3 (2.9)
Delay in getting preoperative laboratory results	12 (11.4)
Delay in patients/next-of-kin giving consent for surgery	2 (1.9)
Faulty equipment	1 (1.0)
Delay in transferring patient and lack of theater space	6 (5.7)
Patient’s lack of finance	16 (15.2)

Note:

* Major reasons for delay listed once.

Abbreviation: DIT, decision-to-intervention time.

Table 4 Therapeutic outcome of emergency gynecological surgeries*

Variables	N (%)
Outcome
Estimated blood loss <1,000 mL	40 (38.1)
Estimated blood loss ≥1,000 mL	65 (61.9)
Received blood transfusion	60 (57.1)
Anemia	38 (36.2)
Sepsis	10 (9.5)
DIC	1 (1.0)
Hemorrhagic shock	19 (18.1)
Renal failure	2 (1.9)
Death	6 (5.7)

Note:

* Therapeutic outcome of participants listed more than once.

Abbreviation: DIC, disseminated intravascular coagulopathy.

Table 5 Comparison of therapeutic outcome between those with DIT less than or equal to and greater than 120 minutes

Variables	N	RR at 95% CI	P-value
Outcome and DIT
Estimated blood loss ≥1,000 mL	65	1.63 (1.22–2.16)	0.0004*
Need for blood transfusion	60	1.33 (1.01–1.76)	0.03*
Hemorrhagic shock	19	4.52 (2.98–6.87)	<0.0001*
Anemia	38	1.76 (1.32–2.36)	<0.00005*
Sepsis	10	9.50 (5.25–17.2)	<0.0001*

Notes:

* Statistically significant. N=105.

Abbreviations: DIT, decision-to-intervention time; CI, confidence interval; RR, risk ratio.