A nationwide cohort study of short- and long-term outcomes following emergency laparotomy

Abstract

Introduction: Emergency laparotomy is a high-risk procedure associated with severe post-operative morbidity and high mortality. The aim was to conduct a nationwide cohort consisting of all patients undergoing emergency laparotomy during an 11-year period and to examine both short- and long-term outcomes.

Methods: Adult patients treated with emergency laparotomy due to gastrointestinal conditions from 2003 through 2013 were identified in the Danish National Patient Register. Demographic data and surgical outcomes were identified in nationwide registers.

Results: A total of 47,300 patients were included in the study. Hereof, 15,015 patients underwent minor laparotomy (open appendectomy or cholecystectomy) and the rest underwent major laparotomy (n = 32,285). In all, 8,193 patients (17.3%) were readmitted within 30 days from surgery, whereas 7,521 patients (15.9%) underwent gastrointestinal reoperation. A total of 10,944 patients (23.1%) experienced a post-operative complication. The post-operative mortality at 7, 30, 90 and 365 days was 8.5%, 13.3%, 16.9% and 21.9%, respectively. When excluding minor laparotomies (open appendectomy and cholecystectomy), the 7-, 30-, 90- and 365-day mortality was 12.1%, 18.7%, 23.6% and 30.5%, respectively.

Conclusions: More than one in every five patients died within one year after undergoing emergency laparotomy, and mortality rates were even higher when excluding minor laparotomies as almost one in every three patients died within one year.

Funding: This study received support from the Frimodt-Heinecke Foundation and from the foundation Manufacturer Frands Køhler Nielsens and wife memorial fund.

Trial registration: The study was registered with Researchregistry.com (Id no: researchregistry2930).