Complications after emergency laparotomy beyond the immediate postoperative period - a retrospective, observational cohort study of 1139 patients.
Mortality and morbidity occur commonly following emergency laparotomy, and incur a considerable clinical and financial healthcare burden. Limited data have been published describing the postoperative course and temporal pattern of complications after emergency laparotomy. We undertook a retrospective, observational, multicentre study of complications in 1139 patients after emergency laparotomy. A major complication occurred in 537/1139 (47%) of all patients within 30 days of surgery. Unadjusted 30-day mortality was 20.2% and 1-year mortality was 34%. One hundred and thirty-seven of 230 (60%) deaths occurred between 72 h and 30 days after surgery; all of these patients had complications, indicating that there is a prolonged period with a high frequency of complications and mortality after emergency laparotomy. We conclude that peri-operative, enhanced recovery care bundles for preventing complications should extend their focus on continuous complication detection and rescue beyond the first few postoperative days.
Copenhagen University Hospital, Hvidovre, Denmark.
L T
LT
Tengberg
Copenhagen University Hospital, Hvidovre, Denmark.
M
M
Cihoric
Copenhagen University Hospital, Hvidovre, Denmark.
N B
NB
Foss
Copenhagen University Hospital, Hvidovre, Denmark.
M
M
Bay-Nielsen
Copenhagen University Hospital, Køge, Denmark.
I
I
Gögenur
Copenhagen University Hospital, Hillerød, Denmark.
R
R
Henriksen
Copenhagen University Hospital, Herlev, Denmark.
T K
TK
Jensen
Copenhagen University Hospital, Herlev, Denmark.
M-B
MB
Tolstrup
Copenhagen University Hospital, Bispebjerg, Denmark.
L B J
LB
Nielsen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D004630:Emergencies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007813:Laparotomy / Q000009:adverse effects* / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011184:Postoperative Period; D012189:Retrospective Studies; D055815:Young Adult
complications; emergency general surgery; laparotomy; mortality; peri-operative medicine