Emergency Laparotomy in Denmark: A Nationwide Descriptive Study

Area of Science:

• Surgery
• Public Health
• Epidemiology

Background:

• Emergency open abdominal surgery encompasses procedures like bowel resection, ostomy placement, and drainage via laparotomy.
• These common surgical interventions carry significant risks of complications and mortality.
• Previous research lacked descriptive analyses of patient demographics and outcomes for these procedures.

Purpose of the Study:

• To provide a nationwide description of patients undergoing emergency open abdominal surgery in Denmark.
• To analyze the incidence rates of emergency laparotomies.
• To report the 30-day and 365-day mortality risks associated with these procedures.

Main Methods:

• Utilized the Danish National Patient Register to identify patients aged 18+ who underwent emergency open abdominal surgery (laparotomy) between 2003 and 2014.
• Employed Poisson and logistic regression models to analyze incidence rates and mortality risks.
• Included a sample of 15,680 patients.

Main Results:

• The incidence rate of emergency open abdominal surgery was 30.4 cases per 100,000 person-years.
• The overall 30-day mortality risk was 19.3%, increasing significantly with age.
• A notable decrease in 30-day mortality risk was observed during the study period, from 22.2% to 16.7%.

Conclusions:

• Emergency open abdominal surgery is a high-incidence, high-risk procedure, with elderly patients facing the greatest mortality risk.
• While incidence and mortality rates declined between 2003-14, the findings highlight a lack of standardized post-discharge care for emergency laparotomy patients in Denmark.
• The study underscores the necessity of developing standardized post-operative follow-up and rehabilitation plans to mitigate mortality risks.