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Benchmarking against the National Emergency Laparotomy Audit recommendations
Yiu Ming Ho1,2, Julie Cappello1, Ramin Kousary1
1Department of Surgery, Logan Hospital, Logan City, Queensland, Australia.
ANZ Journal of Surgery
|September 21, 2017
Summary
Emergency laparotomy mortality at Logan Hospital was 9.7%, comparing favorably with the National Emergency Laparotomy Audit (NELA) results. Further Australian data and adherence to NELA guidelines may enhance patient outcomes.
Area of Science:
- Surgical outcomes research
- Public health surveillance
Background:
- The National Emergency Laparotomy Audit (NELA) established benchmarks for emergency abdominal surgery in England and Wales.
- Regional Australian hospitals' surgical outcomes require comparison with established national audits.
Purpose of the Study:
- To compare emergency abdominal surgical care and mortality at Logan Hospital, Queensland, Australia, with NELA findings.
- To assess the 30-day mortality rate for emergency laparotomy patients at Logan Hospital.
Main Methods:
- Retrospective analysis of patient data from May 2010 to April 2015.
- Identification of patients undergoing emergency laparotomy within 30 days of death.
- Extraction and analysis of health records for 350 patients.
Main Results:
- The 30-day mortality rate for emergency laparotomy was 9.7% over the 5-year period.
- Key mortality factors included patient age, P-POSSUM score, and admission source.
- No significant differences in antibiotic timing, perioperative medical service use, or ICU admission frequency were observed between survivors and non-survivors.
Conclusions:
- Logan Hospital's emergency laparotomy mortality rate is comparable to NELA's reported 11.1%.
- Case mix and patient risk profiles (P-POSSUM) may influence mortality comparisons.
- Further Australian data and improved adherence to NELA recommendations are suggested to enhance outcomes.
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