Patient reported outcomes of emergency general surgery procedures

Abstract

Background: Emergency 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).

Methods: We 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.

Results: Among 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.

Conclusions: PROMs 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.

Keywords: Communication; Decision-making; EGS; Mixed methods; PROMs.