Scientific Foundations of Medical Care Improvement for Elderly People With Acute Abdomen

Main Article Content

Bauyrzhan Ashirov
Myrzatay Buleshov
Daniyar Buleshov
Aizhan Buleshova
Kanatzhan Kemelbekov

Keywords

risk factors of prehospitalmortality, periodic health examination, “acute abdomen”, audio and video technologies, surgical activity

Abstract

Basic tendencies in the emergency surgical measures in case of acute diseases of the abdominal cavity organs within 2019-2021 are discussed in the study.
The purpose of the study is establishment of main risk factors of pre-hospital mortality development due to complications of acute surgical diseases of the abdominal organs(ASDAO), effectiveness of primary prevention improvement, its diagnosis and management using innovative technologies.
Methods of the study. A comparative analysis of the indicators covering 4 city health care centers where more than 90% of emergency surgeries are performed in case of acute diseases of the abdominal cavity organs of adult population in case of some disease entities combined by the general concept “acute abdomen”.
Outcomes. Main risk factors of acute surgical pathologies of theabdominal cavity organs development are low responsibility of people for preservation of their health, nonobservance of dietary pattern, eating of badly digestible food, alcoholic beverages, hypodynamia, absence ofregular medical check-upof the patients with chronic pathologies ofdigestive tract, planned hospital admissionandsurgical treatment of the patients with ASDAO.
The use of audio and video technologies during the medical examination of the abdominal patients has increased for 2019-2022 from 65.43% to 81.31%, a number of patients subject to qualitative planned screening examinations has increased by15.21%, timeliness of medical-preventive activities has been increased by 11.16%, level of planned laboratory-instrumental examination techniques has been grown by 17.72% resulting in increase of share of the patients (11.16%) who were surgically treated on time.
Improvement of quality of theperiodic health examination of the patients with chronic pathologies of the abdominal cavity organspromotedreduction in the burden of acute appendicitis by 1.19%0, acute pancreatitis by 0.79%0, acute cholecystitis by 0.67%0, gastroduodenal ulcer by 0.48%0.

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References

1. Buleshov M.A., Buleshova A.M., Tuktibayeva S.A., Ashirov B.O., Ilimova A.K., ChulpanovU.Yu. Scientific substantiation of medico-social prevention of digestive diseases in schoolchildren on the basis of the prediction //Electron J Gen Med 2019;16(6): em180. p 81-87.
2. AshirovB. O., Buleshov М.А., Ilimova А. K., BuleshovaА.М., Kyrgyzova К. Sh. Zhitikursaksindromynaalypkeletinsozylmalykhirurgiyalykpatologiyalary bar naukastardydispanserlikbakylaugaalutiimdiliginbagalau[Evaluation of the effectiveness of medical supervision of patients with chronic surgical pathologies leading to acute abdominal syndrome] //Annals of KazNMU, No. 4, 2020.
3. Ardak Nurbakyt, Andrej Grjiboski,Galina Kaussova, MyrzatayВuleshov. Epidemiology of Gastrointestinal Disease among Children and Adolescents in Kazakhstan: 2012–2019// Macedonian Journal of Medical Sciences. 2021 Oct 06; 9(E):1244-1249. Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access. https://doi.org/10.3889/oamjms.2021.6931 eISSN: 1857-9655 Category: E - Public Health Section: Public Health Epidemiology
4. Fernandez D.C., Fernandez D.C., Lozares S.A., Moreno S.J. at al. Age as predictive factor of mortality in an intensive and intermediate care unit // Rev. Esp. Geriatr. Gerontol. 2008. - Jul - Aug. - № 43. - P. 214 - 220.
5. GorelikS. G., LitynskyA. V., PolyakovP. I., Polev А.V. Osobennostikhirurgicheskoipatologii u pozhilykhbolnykh[Features of surgical pathologies of elderly patients] // Basic researches 2014. No. 10-3, p.493-497. URL:http://fundamental-resarch.ru//ru//article//view ?id= 35449
6. Khan M.N., Fayyad T.A., Cecil T.D., Moran B.J. Laparoscopic versus open appendectomy: the risk of postoperative infectious complications // JSLS. -2007. Jul - Sep. - № 11 - p. 363.
7. Egidio A., Schein M. Surgical strategies in the treatment of pancreatic necrosis and infection. //Brit. J. Surg. 1991. - Vol. 78, N 2. - P. 133-137.
8. Freeny PC. Angio CT: diagnosis and detection of complications of acute pancreatitis //Hepatogastroenterology. - 1991. - Vol. 38, N 4. - P. 109-115.
9. Harris J.A., Jurry RP., Catto J. Closed drainage versus open packing of infected pancreatic necrosis //Amer. Surg. 1995. - Vol. 61, N 7. - P. 612617.
10. Hynninen M., Wennervirta J., Leppaniemi A., Pettila V. Organ dysfunction and long-term outcome in secondary peritonitis // Langenbecks Arch. Surg. 2008. - Jan. - P. 86 - 99.
11. Lafreniere R., Berguer R., Seifert P.C., Belkin M. Preparation of the operating room // ACS Surgery: Principles and Practice. 2006. - P. 113126.
12. Ooi L.L., Goh Y.C., Chew S.P. et al. Bile duct injuries during laparoscopic cholecystectomy: a collective experience of four teaching hospitals and results of repair // Department of Surgery, Singapore General Hospital,1. Singapore, 1998.
13. Ranson J.H. The role of surgery in the management of acute pancreatitis // Ann. Surg. 1990. - Vol. 211, N 4. - P. 382-393.
14. Strate T., Knoefcl W., Yekebas E. et al Chronic pancreatitis: etiology, pathogenesis, diagnosis, and treatment. // J. Colorectal Dis. 2003 - Vol. 38. - № 2. -P. 97- 106.
15. Sorensen L.T., Malaki A.A., Wille P.A. et al. Risk factors for mortality and postoperative complications after gastrointestinal surgery // J. Gastrointest. Surg. 2007. - Jul. - № 11. - P. 903 - 910.
16. Uhl W., Warshaw A., Bassi C., McKay C. Guidelines for die surgical management of acute pancreatitis // Pancreatologie. 2002. - Vol. 5. - № 4. - P. 565
17. Acute pancreatitis in Bergen, Norway. A study on incidence, etiology and severity / H. Gislason, A. Horn, D. Hoem, A. Andren-Sanberg, A. K. Imsland, O. Soreide, A. Viste // Scand. J. Surg. 2004. - Vol. 93, № 1. - P. 29-33.
18. Altmeier G. Die acute Cholecystitis. ErfordernisdifferenterTherapiebeijüngeren und altenMenscher / G. Altmeier // Chirurg. 1981. - Bd. 52, № 7. - S. 450-453.
19. Atchley Robert C. Social forces and aging: An introduction to social gerontology / Robert C. Atchley. NY.: Acad. Internet Pabh, 2006. - 148 p.
20. Baradarian R. Early intensive resuscitation of patients with upper gastrointestinal bleeding decreases mortality/R. Baradarian // Am. J. Gastroenterol. 2004. - Vol. 99. - P. 619-622.
21. Buchlor M., Acute pancreatitis. Novel concepts in biology and therapy / M. Buchlor, P. Malferstheiner. Berlin; Viena: Blackwell Wisser-Schfts-Ver lag, 1999.-548 p.
22. Bulut О. В., Acute surgical treatment of complicated peptic ulcers with special reference to the elderly / О. B. Bulut, C. Rasmussen, A. Ficher // World. J. S urg. 1996. - Vol. 20, № 5. - P. 574-577.
23. Causes and clinical outcome of acute upper gastrointestinal bleeding: a prospective analysis of 1534 cases / K.C. Thomopouls et al. // Int. J. Clinic. Practic. 1998. - Vol. 52, № 8. - P. 547-550.