Complications and Their Association with Mortality Following Emergency Gastrointestinal Surgery-an Observational...

Area of Science:

• Surgical Outcomes
• Gastrointestinal Surgery
• Critical Care Medicine

Background:

• Emergency gastrointestinal surgery is associated with substantial risks of severe complications and mortality.
• Identifying specific complications linked to increased mortality is crucial for improving patient outcomes.

Purpose of the Study:

• To determine which complications have the strongest association with 90-day mortality after emergency gastrointestinal surgery for obstruction or perforation.

Main Methods:

• Retrospective analysis of 349 adult patients undergoing emergency gastrointestinal surgery for obstruction or perforation.
• Cox regression with delayed entry was used to assess the association between 16 predefined complications and 90-day mortality.
• Adjustments were made for multiple clinical and demographic factors.

Main Results:

• Over 80% of patients experienced at least one complication.
• Renal impairment (HR: 6.8), arterial thromboembolic events (HR: 4.8), and atrial fibrillation (HR: 4.4) were most strongly associated with 90-day mortality.
• Atrial fibrillation was the only complication significantly linked to death in both obstruction and perforation subgroups.

Conclusions:

• Renal impairment, arterial thromboembolic events, and atrial fibrillation are key predictors of mortality following emergency gastrointestinal surgery.
• Atrial fibrillation may indicate patients requiring intensified care and monitoring.