Long-term outcomes after emergency laparotomy : a retrospective study
Ylimartimo, Aura T.; Lahtinen, Sanna; Nurkkala, Juho; Koskela, Marjo; Kaakinen, Timo; Vakkala, Merja; Hietanen, Siiri; Liisanantti, Janne (2022-06-13)
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). https://doi.org/10.1007/s11605-022-05372-3
© The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
https://creativecommons.org/licenses/by/4.0/
https://urn.fi/URN:NBN:fi-fe2022111665752
Tiivistelmä
Abstract
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.
Kokoelmat
- Avoin saatavuus [31941]