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Long-term Outcomes After Emergency Laparotomy: a Retrospective Study.

Aura T Ylimartimo1,2, Sanna Lahtinen3,4, Juho Nurkkala3,4

  • 1Medical Research Center of Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu, Finland. aura.ylimartimo@ppshp.fi.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|June 13, 2022
PubMed
Summary

Long-term mortality after emergency laparotomy (EL) is significant, with 18% of patients dying during follow-up. Higher American Society of Anesthesiologists (ASA) classification and Charlson Comorbidity Index (CCI) scores are key predictors of poor outcomes in EL patients.

Keywords:
Emergency laparotomyLong-term outcomesMortality

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Area of Science:

  • Surgery
  • Geriatric Medicine
  • Critical Care Medicine

Background:

  • Emergency laparotomy (EL) is a frequent surgical procedure associated with high morbidity and mortality.
  • Patients undergoing EL often present with frailty and multiple chronic health conditions.
  • Limited research exists on the long-term health outcomes following emergency laparotomy.

Purpose of the Study:

  • To investigate the long-term mortality rates after emergency laparotomy.
  • To identify factors associated with increased mortality in patients who survive the initial postoperative period.

Main Methods:

  • A retrospective cohort study was conducted involving 674 adult patients who underwent midline EL.
  • Follow-up data were collected until September 2020, with a primary endpoint of 2-year mortality.
  • Cox regression analysis was used to determine factors associated with mortality.

Main Results:

  • Out of 554 patients surviving beyond 90 days, 120 (18%) died during the follow-up period.
  • Non-survivors were significantly older than survivors (median age 71 vs. 64 years).
  • Factors associated with increased mortality included longer operation duration, higher ASA classification, elevated CCI score, and postoperative medical complications.

Conclusions:

  • Patient-related factors, specifically higher ASA classification and CCI scores, are strongly linked to adverse long-term outcomes and mortality post-EL.
  • These findings highlight the importance of comprehensive risk assessment and management for patients undergoing emergency laparotomy.