SPECTRUM OF ACUTE GENERAL SURGICAL ADMISSIONS AND FACTORS ASSOCIATED WITH DISEASE GROUPS: A CROSS-SECTIONAL STUDY FROM TERTIARY CARE HOSPITAL IN LAHORE, PAKISTAN
Keywords:
Emergency general surgery; Case mix; Diabetes mellitus; Soft-tissue infection; Typhoid perforation; Road traffic injuries; PakistanAbstract
Background: Emergency general surgery places a heavy burden on hospitals in low- and middle-income countries, but recent Pakistani data on its case mix and associated patient factors are limited. Hence, this study aims to assess spectrum of acute general surgical admissions and identify associated patient factors.
Methods: This retrospective cross-sectional study reviewed 20 available departmental emergency reports of patients admitted to general surgery ward from May to August 2026 at Surgical Unit 1, Services Hospital, Lahore. Admissions were grouped into eight disease categories and compared with chi-square, Fisher's exact and Kruskal-Wallis tests; diabetes was assessed with logistic regression adjusted for age and sex and p value equal to or less than 0.05 considered statistically significant.
Results: Of 169 general surgery admissions, 61.5% were male; mean age was 38.9 ± 16.3 years. Appendicitis (26.6%) and gallbladder or pancreatic disease (19.5%) were commonest, followed by soft-tissue infections (14.2%), trauma (12.4%), peritonitis (10.1%) and complicated hernias (7.7%). Gallbladder disease was predominantly female (69.7% vs 30.9%, p < 0.001) and all managed conservatively in emergency. Appendicitis accounted for 11 of 19 children, while 10 of 12 hernia patients were aged 50 or older. Diabetes was independently associated with soft-tissue infection (adjusted OR 11.9, 95% CI 3.8–37.0, p = < 0.05), and 6 of 8 diabetic foot patients underwent major amputation. Typhoid was the commonest non-appendiceal cause of peritonitis, and 39.3% of laparotomies ended with a stoma.
Conclusion: Appendicitis and gallstone disease dominated emergency admissions, each with a distinct age and sex profile. Diabetes was strongly and independently linked with limb-threatening infection, and much of the remaining workload, including typhoid perforation and diabetic foot sepsis, was potentially preventable.
