Exploring the experiences of surgical patients admitted with non-trauma gastrointestinal disorders: A qualitative study

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s / International Journal of Surgery 23 (2015) S15eS134 S111 0146: EXPLORING THE EXPERIENCES OF SURGICAL PATIENTS ADMITTED WITH NON-TRAUMA GASTROINTESTINAL DISORDERS: A QUALITATIVE STUDY J. Mason, A. McNair, N. Blencowe, D. Stevens, K. Avery, A. Pullyblank, J. Blazeby. University of Bristol, UK Aim: The RCSEng recommends the use patient reported outcome data in surgical trials, although there are no validated questionnaires to measure these outcomes within emergency surgery. The aim of this study, therefore, was to explore the views of patients admitted with unplanned abdominal problems. Methods: Semi-structured interviews were conducted with a purposive sample of patients admitted to SAU at 2 acute hospitals in the South West of England. Interviews explored patients’ experiences regarding their illness, treatment and recovery. Analysis was an on-going iterative process, occurring concurrently alongside data collection. Results: Fourteen semi-structured patient interviews were carried out (10 females, median age 51.5, range 27e77) covering the spectrum of nontrauma emergency surgery presentations. Six patients were treated conservatively, while 8 patients underwent either endoscopy or surgery. All patients reported abdominal pain as the primary reason for seeking medical attention. Immobilisation was the main consequence of pain regardless of age. Treatment related complications were more common in patients who underwent surgery, and were associated with a prolonged period of immobility during recovery. Conclusion: Patients admitted with unplanned abdominal problems report a similar collection of experiences. Future work should focus on the development of a core outcome set for this patient population. 0160: WHO DOES IT BETTER? COMPARISON OF TRAUMA CARE AND PELVIC BINDER USE AT TWO HOSPITALS IN WALES J. Clutton , L. Moulton , J. Organ , C. Carpenter . University Hospital of Wales, UK; Ysbyty Gwynedd, UK Aim: To compare the standard of care of the Severely Injured Patient (SIP) between a DGH and a teaching hospital. Methods: All trauma calls for a one-year period were reviewed retrospectively. Attendance distribution, proportion of trauma calls undergoing CT, time to CT, and initial management of suspected pelvic injuries were reviewed. Our standards were Royal College of Radiologists' guidelines, and the 2007 NCEPOD report. Results: We reviewed 270 trauma patients in total (190 at the teaching hospital, 80 at the DGH). Incidence of pelvic fractures was equal at both sites (10%). At the DGH, SIPs were more likely to have a CT scan, have a pelvic binder applied, and have this applied correctly. At the teaching hospital, time to CT was significantly faster (p <0.01), and patients were more likely to have a binder on a fractured pelvis. Time to CT increased by 30% at both sites out of hours. Conclusion: Both hospitals have room to improve care of SIPs. Delay to CT at the DGH is likely to be due to hospital layout, and increased time to CT out of hours due to decreased resources. Improvements are needed at both sites to decrease the delay to CT. 0182: THE EMERGENCY LAPAROTOMY; POST-OPERATIVE MORTALITY AND LENGTH OF STAY IN HOSPITAL N. Stephens, R. Dolan, H. Dorrance. Victoria Infirmary, UK Aim: A contemporary study in England showed a 30 day mortality rate of 15.6% for patients undergoing emergency laparotomies. We aim to assess the mortality and length of stay following emergency laparotomies. Methods: Electronic and paper based theatre logbooks were searched to identifyall consecutivepatientsundergoingemergency laparotomiesovera6 month period. Patients’ online electronic clinical records were also reviewed and demographics, diagnosis, procedure and outcome documented. Results: 70 patients (male: 32, female: 38) were included in the study. Median (SD) age was 61 (19) years (range 21e92 years). The most common reason for a laparotomy was for bowel obstruction which accounted for 15.7% of cases. Perforated diverticular disease accounted for 14.3% of cases, while stabbings and blunt force trauma accounted for 4.3% of cases. Median length of stay in hospital was 17 (19) days (range 1e115), while the median time from laparotomy to dischargewas 15 (17) days (range 1e109). 30 day mortality rate was 11%. Conclusion: This study has demonstrated low post-operative mortality rates following emergency laparotomy at our institution. Although length of stay in hospital post-operatively was just over 2 weeks, therewas awide range (up to 109 days) which deserves further exploration. 0213: APPENDICECTOMY PRE AND POST INTRODUCTION OF A DEDICATED EMERGENCY SURGICAL UNIT P. Karayiannis, N. McKinley, R. Lambon, B. Clements. Royal Victoria