Unplanned reoperations: is emergency surgery a risk factor? A cohort study

Area of Science:

• General Surgery
• Surgical Quality Improvement
• Patient Safety

Background:

• Unplanned reoperations are a potential indicator of surgical quality but lack extensive risk factor analysis.
• Understanding factors influencing reoperations is crucial for improving surgical outcomes.

Purpose of the Study:

• To investigate the risk factors for unplanned reoperations in a tertiary general surgery service.
• To determine the association between emergency surgery and the likelihood of reoperation.
• To assess the impact of reoperations on mortality and length of hospital stay.

Main Methods:

• Prospective cohort study of patients undergoing surgery between July 2007 and February 2008.
• Primary endpoint: unplanned reoperations within 30 postoperative days.
• Multivariate logistic regression analysis adjusted for patient and surgical covariates.

Main Results:

• Cumulative incidence of unplanned reoperations was 5.9%.
• Emergency surgery was associated with a 2.83-fold increased odds of reoperation (adjusted).
• Reoperation significantly increased mortality risk (8.94-fold) and extended hospital stay (mean 19 vs. 3 days).

Conclusions:

• Initial emergency surgery in a tertiary general surgery setting significantly elevates the risk of unplanned reoperations.
• Unplanned reoperations serve as critical indicators of increased mortality and prolonged hospitalization.
• These findings highlight the need for careful management of emergency surgical cases to mitigate adverse outcomes.