Perioperative Management of Anemia in Emergency Abdominal Surgery at the National Hospital of Niamey

Abstract

Aim of the study: To describe the perioperative care of anemia in emergency abdominal surgery in the National Hospital of Niamey. Patients and methods: This was a prospective and descriptive study that lasted 6months, from June 6th to December 9th, 2020. Were inclueded in the study, all the patients admitted in the department of surgical emergencies who presented acute surgical abdomen associated with anemia. The main studied variables were: age, gender, history, CBC results, American Society of Anesthesiologists score (ASA), indications, etiological diagnosis, incidents and intraoperative accidents, post operative complications, treatment of the anemia, evolution and duration of hospitalization. Statistical analysis of the data was done using SPSS version 25, graphics and data entry were done with Word and Excel 2016 softaware. The average values were calculated for each variable for each patient and examinated by the chi² test for qualitative variables. P value < 0,05 was considered as significant. Results: Our study involved 147 patients out of 581 admissions, i.e a frequency of 25.30%. the average age of the patients was 16.27 years with extremes of 2 and 70 years, the male gender predominated with 64.63% (n=95) and a sex ratio of 1.83. The main preoperative diagnosis was acute peritonitis in 78.91% f cases (n=120) and peritonitis by ileal perforation was the first etiology with 63.94% (n=94). The majority of our patients had moderate preoperative anemia in 73.47% (n=108) and severe anemia in 21.09% (n=31) of cases. The management of anemia was based on blood transfusion which was performed in 10.20% of cases (n=15) preoperatively and 32.65% of cases (n=48) intraoperatively. In the postoperative period, the treatment of anemia was essentially based on oral iron supplementation. Intra operative incidents and accidents were significantly associated with the severity of anemia preoperatively. Parietal suppuration was the main postoperative complication, ie 70.6% ..