Surgical outcomes among internally displaced persons during armed conflict in Sudan: a retrospective study from a referral emergency hospital

Background The ongoing armed conflict in Sudan has resulted in widespread internal displacement and severe disruption of healthcare services, limiting access to timely surgical care. Internally displaced persons (IDPs) frequently present with advanced surgical conditions and are at increased risk of adverse postoperative outcomes. However, evidence describing surgical outcomes among IDPs in Sudan remains limited. This study aimed to evaluate the pattern of surgical disease, postoperative outcomes, and factors associated with poor surgical outcomes among internally displaced persons undergoing surgery at Rabak Teaching Hospital during the armed conflict in Sudan. Methods A retrospective hospital-based observational study was conducted at Rabak Teaching Hospital, White Nile State, Sudan. Medical records of 206 internally displaced patients who underwent surgical procedures between April 2023 and September 2024 were reviewed. Additional postoperative follow-up and patient satisfaction data were collected through telephone interviews with all participants. Descriptive statistics were used to summarize the data. Associations between categorical variables were assessed using the Chi-square test or Fisher's exact test where appropriate. Multivariable binary logistic regression analysis was performed to identify independent predictors of poor surgical outcomes, with statistical significance set at p < 0.05. Results Among the 206 patients included in the study, 125 (60.7%) underwent emergency surgery. Benign surgical conditions (28.6%), acute abdominal conditions (21.8%), infection-related conditions (20.4%), and trauma (20.3%) were the most common surgical presentations. Postoperative complications occurred in 83 (40.3%) patients, with surgical site infection being the most frequent complication (16.0%). At postoperative follow-up, 122 (59.2%) patients achieved full recovery, whereas 84 (40.8%) experienced a poor surgical outcome. Increasing age, emergency surgery, and the occurrence of postoperative complications were independently associated with poor surgical outcomes. Conclusion Internally displaced persons undergoing surgery during the armed conflict in Sudan experienced a high burden of emergency surgical disease and postoperative complications. Increasing age, emergency surgery, and postoperative complications were independently associated with poor surgical outcomes. Strengthening emergency surgical services, infection prevention and control measures, perioperative care, and referral systems may improve surgical outcomes for displaced populations in humanitarian settings.