Outcomes of Emergency Surgical patients with acute pathology managed without emergency laparotomy - a single site review

Abstract

Abstract Aim To establish the outcomes of Emergency General Surgery patients admitted with acute pathology that did not progress to Emergency Laparotomy Method Retrospective single site review of all Emergency General Surgery patients admitted over three calendar months. Review of patient demographics, diagnostics, diagnosis and management. Identification of and further collection of data from electronic patient records for patients that did not proceed to Emergency Laparotomy despite indicative pathology. Results A total of 619 emergency general surgical patients were admitted from 1st January to 31st March 2023. 39 (6.3%) patients had an Emergency Laparotomy. 17 (2.7%) patients did not proceed to laparotomy despite pathology that could indicate the need for emergency laparotomy. 100% of these patients has CT imaging to diagnose the pathology. Of the 17 patients without laparotomy 12 were female patients. Median age of 86 years (range 42 – 91 years). At 30 days post admission 6 patients who did not proceed to laparotomy were alive. 7 patients survived to discharge, 5 were discharged home and 2 were discharged to a Nursing Home for full nursing care requirements. Conclusion Surgeons are starting to explore the issues around futility in emergency general surgery. This snapshot retrospective review shows alignment with the very limited published literature. We recognise our numbers are extremely limited. Further data collection and analysis is needed to explore futility in emergency general surgery.