Enrolling high-acuity emergency general surgery patients in a prospective longitudinal cohort study

Over 3 million patients are admitted to hospitals annually with high-acuity conditions mandating emergency abdominal or skin/soft-tissue operations. Patients with these high-acuity emergency general surgery (HA-EGS) diseases experience significant morbidity and mortality, yet the quality-of-life impact on survivors is not well studied. Acuity, transfer patterns, and adverse social determinants of health documented in epidemiologic studies are cited reasons for inability to measure patient-reported outcomes among HA-EGS survivors. We conducted a feasibility study to understand facilitators/barriers to conducting prospective studies of changes in quality of life after surviving HA-EGS. From September 2019 to April 2021, we collected baseline (preadmission) and 30/60 days' postsurgery data on activities of daily living, depression, self-efficacy, resilience, pain, work limitations, social support, and substance use from patients who enrolled in the study during index hospitalization. One hundred patients consented to participate (71.9% enrollment rate). The retention rate was 65.9% for 30-day follow-up telephone calls and 53.8% for 60-day follow-up calls. Median time needed to complete each time point remained under 25 minutes. Patients with a longer length of stay and nicotine users had higher odds of not completing their 30-day interview, while those with systemic complications had higher odds of not completing their 60-day interview. These results lay the foundation for future patient-reported outcome studies.