University of Oulu

Ylimartimo, A.T., Lahtinen, S., Nurkkala, J. et al. Long-term Outcomes After Emergency Laparotomy: a Retrospective Study. J Gastrointest Surg 26, 1942–1950 (2022).

Long-term outcomes after emergency laparotomy : a retrospective study

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Author: Ylimartimo, Aura T.1,2; Lahtinen, Sanna1,3; Nurkkala, Juho1,3;
Organizations: 1Medical Research Center of Oulu, Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Oulu, Finland
2Department of Surgery, Oulu University Hospital, P.O.BOX 21, 90029 OYS, Oulu, Finland
3Department of Anesthesiology, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
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Language: English
Published: Springer Nature, 2022
Publish Date: 2022-11-16


Background: Emergency laparotomy (EL) is a common surgical operation with poor outcomes. Patients undergoing EL are often frail and have chronic comorbidities, but studies focused on the long-term outcomes after EL are lacking. The aim of the present study was to examine the long-term mortality after EL.

Methods: We conducted a retrospective single-center cohort study of 674 adults undergoing midline EL between May 2015 and December 2017. The follow-up lasted until September 2020. The primary outcome was 2-year mortality after surgery. The secondary outcome was factors associated with mortality during follow-up.

Results: A total of 554 (82%) patients survived > 90 days after EL and were included in the analysis. Of these patients, 120 (18%) died during the follow-up. The survivors were younger than the non-survivors (median [IQR] 64 [49–74] vs. 71 [63–80] years, p < 0.001). In a Cox regression model, death during follow-up was associated with longer duration of operation (OR 2.21 [95% CI 1.27–3.83]), higher ASA classification (OR 2.37 [1.15–4.88]), higher CCI score (OR 4.74 [3.15–7.14]), and postoperative medical complications (OR 1.61 [1.05–2.47]).

Conclusions: Patient-related factors, such as higher ASA classification and CCI score, were the most remarkable factors associated with poor long-term outcome and mortality after EL.

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Series: Journal of gastrointestinal surgery
ISSN: 1091-255X
ISSN-E: 1873-4626
ISSN-L: 1091-255X
Volume: 26
Issue: 9
Pages: 1942 - 1950
DOI: 10.1007/s11605-022-05372-3
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Funding: Open Access funding provided by University of Oulu including Oulu University Hospital.
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