Rena Kyriakides (Liverpool / GB), Elizabeth O'Connell (Liverpool / GB), Olga Rutka (Liverpool / GB), Nikhil Misra (Liverpool / GB)
Abstract text (incl. references and figure legends)
Introduction
Liverpool's EGS service is one of the first dedicated trauma and emergency surgery units in the UK, offering a collaborative approach to patient care with other general surgical specialties.
Objective
To assess the clinical outcomes in emergency laparotomies from a dedicated EGS service, with a collaborative model of care involving all other specialty teams.
Methods
A prospective database of all patients undergoing an emergency laparotomy between 1st June 2014 and 30th June 2022 at our institution was retrospectively analysed. Data were analysed using SPSS software.
Results
1403 patients who underwent an emergency laparotomy were identified between 2014 and 2022, of which 583 were operated by the EGS service, and 820 during out of hours (OOH). Mean PPOSSUM predicted mortality was 15.61 for EGS patients and 16.10 for OOH. In 78% of EGS cases a consultant was recorded as being present, compared to 57.1% of OOH services, which was statistically significant (p<0.00007). 81.3% of EGS patients were admitted to ITU/HDU post operatively with average stay of 6.4 days, compared to 82.2% of OOH who were admitted for an average of 6.7 days (national average 82.3%), which was statistically significant (p<0.005). Length of stay for EGS patients was 19.3 days, compared to 22.5 days for OOH patients, p=0.32 (national average of 15.1). 30-day crude mortality for the EGS service was 10%, compared to 13.3% for OOH, which showed no significant difference (p = 0.11) and was comparable to the national average of 8.7%.
Conclusion
A dedicated consultant led EGS service has resulted in positive outcomes in mortality and length of ITU and hospital stay which are comparable to the national average. This has been achived through a hollistic and collaborative care.
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