Emergency laparotomy at St Olav's Hospital, Trondheim.

Abstract

Emergency laparotomies are associated with higher mortality and longer hospital stays than elective laparotomies. The purpose of this study was to survey patient characteristics, hospital care pathways, and mortality for patients undergoing emergency laparotomy at St Olav's Hospital, Trondheim. This is a retrospective cohort study of all patients over 18 years of age who underwent emergency laparotomy at St Olav's Hospital, Trondheim, between 1January 2015 and 1April 2020. Patients were selected based on National Emergency Laparotomy Audit inclusion and exclusion criteria. Surgeries due to trauma or appendicitis were excluded, as were those for gynaecological or vascular aetiology. Patient and surgery characteristics, as well as date of death, were retrieved from electronic medical records. A total of 939 patients with a median (interquartile range) age of 68 years (54-76) were included. Intestinal obstruction was the primary indication for surgery in 488 (52.0%) patients, followed by perforation in 220 (23.4%) and ischaemia in 85 (9.1%). In all, 788 (83.9%) patients underwent emergency surgery within the timeframe scheduled. The median postoperative hospital stay was 10 days (6-18) and 30-day mortality was 8.2%. Although caution should be exercised when comparing findings between studies, our results suggest that the quality of treatment at St Olav's Hospital, Trondheim, is on a par with that at similar institutions. At the same time, the study provides an opportunity to identify areas for improvement in the provision of emergency surgery.