Elizabeth O'Connell (Liverpool / GB), Rena Kyriakides (Liverpool / GB), Olga Rutka (Liverpool / GB), Nikhil Misra (Liverpool / GB), Alexandra Cosariu (Liverpool / GB)
Abstract text (incl. references and figure legends)
Introduction
Emergency laparotomies have a variable level of mortality and morbidity worldwide. Studying the causes and times of mortality in this patient cohort, could enable better patient care and improve future outcomes for these patients. We aimed to investigate the mortality data in laparotomy patients to investigate for trends in mortality and other patient and process characteristics.
Methods
Data for all emergency laparotomies undertaken between 2014 to 2022 were collected prospectively and retrospectively analysed. The Primary outcome was inpatient mortality. Demographics, clinical management and outcome data from this cohort was analysed using SPSS.
Results
1410 laparotomies were undertaken, with an overall crude mortality rate of 11.9% ages ranged between 18-95 (mean = 72.5). The P-POSSUM mortality and morbidity scores for these patients ranged from 2-99 (mean 42.4) and morbidity 40.1-100 (mean 86.6) respectively. The time from date of operation from to death ranged from 24 hours to 123 days (mean = day 11.75), with a uni-modal distribution. In the first 48 hours post-operatively 28.57% (N = 56 patients) died, with a mean age of 70.6 and a mean P-POSSUM of 48.1 (SD 30.6). Within this group bowel perforation (N = 19 patients) and bowel ischaemia (N = 13 patients) where the most common intra-operative finding. The patients that died after 48 hours (N = 116 patients) had a mean age of 73.5 (SD 12.4) and a mean P-POSSUM of 39.6 (SD 29.9, P 0.92), compared to the patients that survived admission (N = 1241) with a mean age of 61.4 (SD 16.4) and a mean P-POSSUM of 15.6 (P>0.01)
Conclusion
Emergency laparotomy has a high level of mortality and morbidity, with the first 48 hours carrying the highest risk particularly in those with bowel perforation or ischaemia.
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No conflict of interest to declare