Timely versus Delayed Operation in Infants with Correctable Congenital Anomalies: A Survey in Isfahan, 2000-2001
Abstract
Background: Unless performing a timely and appropriate correction, congenital anomalies can conduce to irrecoverable complications. There are different reasons for delay in referring such patients to physician for surgery. By understanding these considerations, we can make an effective approach to reduce the severity of this problem in our community and this is the aim of our study.
Methods: In a cross sectional study, all 359 eligible cases (neonates and infants suffered from a correctable anomaly which were referred to our centers) and 110 physicians were included for a period of 15 months (2000-2001). Two main hospitals in our city were set as the data collection centers (Al-Zahra). Parents' views were extracted by interview. Physicians' knowledge about study subject was assessed by self administered MCQs.
Results: In this study 65 percent of all cases who were operated on had been taken to hospital with delay (male to female ratio was 4:1). Among the cases who received delayed surgical treatment, inguinal hernia was the most prevalent one (39 percent). Surgery in 32 percent of cases who had delay in their operation caused some degrees of complications. Physicians' misadvise (42 percent), economic problems (25 percent), and hospital terror (17 percent) were accounted as the most prevalent reasons for delayed referrals. Physicians' knowledge about the correctable congenital anomalies in infants was estimated very poor (3 score from 10).
Discussion: Delay to refer for operation in correctable congenital anomalies is an important dilemma in our community. Public education and also health professional education about this matter can play an admissible role improving the situation. Also, it is needed to make decisions for improving assurance supports in such cases.
Key words: Congenital anomalies, timely treatment, delayed surgery, attitude
Methods: In a cross sectional study, all 359 eligible cases (neonates and infants suffered from a correctable anomaly which were referred to our centers) and 110 physicians were included for a period of 15 months (2000-2001). Two main hospitals in our city were set as the data collection centers (Al-Zahra). Parents' views were extracted by interview. Physicians' knowledge about study subject was assessed by self administered MCQs.
Results: In this study 65 percent of all cases who were operated on had been taken to hospital with delay (male to female ratio was 4:1). Among the cases who received delayed surgical treatment, inguinal hernia was the most prevalent one (39 percent). Surgery in 32 percent of cases who had delay in their operation caused some degrees of complications. Physicians' misadvise (42 percent), economic problems (25 percent), and hospital terror (17 percent) were accounted as the most prevalent reasons for delayed referrals. Physicians' knowledge about the correctable congenital anomalies in infants was estimated very poor (3 score from 10).
Discussion: Delay to refer for operation in correctable congenital anomalies is an important dilemma in our community. Public education and also health professional education about this matter can play an admissible role improving the situation. Also, it is needed to make decisions for improving assurance supports in such cases.
Key words: Congenital anomalies, timely treatment, delayed surgery, attitude