Patient reported outcomes of emergency general surgery procedures

Abstract

BackgroundEmergency general surgery (EGS) involves care of a patient's often previously unknown disease in the setting of an unplanned interaction with the healthcare system. This leads to challenges collecting and interpreting patient reported outcome measures (PROMs). MethodsWe performed a qualitative and mixed methods study using semi-structured interviews during the index hospitalization and at 6–12 months to capture peri-operative patient experiences. We compared interview findings to clinical characteristics. ResultsAmong 30 patients, two-thirds reported feeling no choice but to pursue emergency surgery with many reporting exclusion from decision-making. Females reported these themes more commonly. Patients with minor complications less frequently reported trust in their team and discussed communication issues and delays in care (all p ​< ​0.05). Patients with major complications more frequently reported confidence in their team and gratefulness, but also communication limitations (all p ​< ​0.05). Patients not admitted to the ICU more frequently discussed good communication and expeditious treatment. ConclusionsPROMs developed for EGS patients should consider patient outcomes and reflections that they felt excluded from decision-making. Severity of complications may also differentially impact PROMs.