Outcomes in emergency general surgery following the introduction of a consultant-led unit

Shakerian, Rose; Thomson, Benjamin; Gorelik, Alexandra; Hayes, Ian; Skandarajah, Anita

doi:10.1002/bjs.9954

Cited by 31 publications

(25 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Emergency abdominal surgery is associated with low 30‐ and 90‐day mortality rates of 3.8% and 5.1%, respectively, in a rural Australian surgical centre. These results compare well with data reported from metropolitan centres in Australia (8% mortality) and internationally (4.2% mortality). Emergency abdominal surgery might therefore be safely provided in the non‐metropolitan or rural setting if adequate skillsets and resources are available and if there is support from metropolitan centres should the need for up‐transfer arise.…”

Section: Resultssupporting

confidence: 90%

“…One study reported a 15.6% 30‐day mortality after high‐risk emergency general surgery and identified availability of HDU beds and usage of computed tomography as independent predictors of reduced mortality . Another study recently reported a 53% reduction of postoperative mortality (16.9% to 8%) in emergency general surgery following introduction of a consultant‐led unit in a major Australian university hospital …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mortality after emergency abdominal surgery in a non‐metropolitan Australian centre

Tocaciu

Thiagarajan²,

Maddern

et al. 2018

Australian J Rural Health

View full text Add to dashboard Cite

Objective: Emergency abdominal surgery has poorer outcomes and higher mortality rates, compared with elective surgery. Serious morbidity or mortality occurs in up to 40% of patients. No information is available with regard to the outcome of patients undergoing emergency abdominal surgery in rural Australia. Methods: Patients undergoing emergency abdominal surgery in a 110-bed rural surgical centre in South Australia over a 5 year period (January 2010-December 2014) were included in the study. Patient data were retrieved using the hospital database and review of patient records. Results: A total of 4396 general surgical emergency admissions was recorded. Emergency admissions without intervention, endoscopic intervention only, appendectomy, cholecystectomy or urological or gynaecological diagnoses were excluded from mortality analysis. The remaining 237 patients underwent major abdominal emergency surgery for bowel obstruction (benign and malignant: n = 143, 60%), injury/inflammation/perforation/peritonitis (n = 85, 36%) or haemorrhage/ischaemia (n = 9, 3.8%). Thirty-(n = 9) and 90-(n = 12) day mortality rates were 3.8% and 5.1%, respectively. Conclusion: Emergency abdominal surgery can be safely provided in non-metropolitan Australian centres, with a low 30-day mortality rate of 3.8% and a 90-day mortality rate of 5.1%. This compares well with results published by other national and international investigators.

show abstract

Section: Resultssupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Mortality after emergency abdominal surgery in a non‐metropolitan Australian centre

Tocaciu

Thiagarajan²,

Maddern

et al. 2018

Australian J Rural Health

View full text Add to dashboard Cite

show abstract

“…The acute abdomen is the most frequent non‐trauma surgical reason for emergency hospital admission. Despite a large number of patients undergoing acute high‐risk abdominal (AHA) surgery with a high risk of morbidity and mortality, and substantial socioeconomic costs, there has been limited focus on optimized surgical regimens to improve surgical outcomes. The traditional perioperative treatment of patients undergoing AHA surgery is controversial and founded primarily on non‐standardized treatment practice rather than evidence, and cultural and logistic challenges in emergency surgery are being debated.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary perioperative protocol in patients undergoing acute high-risk abdominal surgery

Tengberg

Bay‐Nielsen

Bisgaard

et al. 2017

British Journal of Surgery

124

150

View full text Add to dashboard Cite

show abstract

“…The outcome following ELs in Australia is unknown with no Australian multihospital study of ELs. A single hospital study included demonstrated 30‐day mortality to be 12% …”

Section: Introductionmentioning

confidence: 99%

The Perth Emergency Laparotomy Audit

Broughton

Aldridge

Pradhan

et al. 2017

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background: Emergency laparotomies (ELs) are associated with high mortality and substantial outcome variation. There is no prospective Australian data on ELs. The aim of this study was to audit outcome after ELs in Western Australia. Methods: A 12-week prospective audit was completed in 10 hospitals. Data collected included patient demographics, the clinical pathway, preoperative risk assessment and outcomes including 30-day mortality and length of stay. Results: Data were recorded for 198 (76.2%) of 260 patients. The 30-day mortality was 6.5% (17/260) in participating hospitals, and 5.4% (19 of 354) across Western Australia. There was minimal variation between the three tertiary hospitals undertaking 220 of 354 (62.1%) ELs. The median and mean post-operative lengths of stay, excluding patients who died, were 8 and 10 days, respectively. In the 48 patients with a prospectively documented risk of ≥10%, both a consultant surgeon and anaesthetist were present for 68.8%, 62.8% were admitted to critical care and 45.8% commenced surgery within 2 h. The mortality in those retrospectively (62; 31%) and prospectively risk-assessed was 9.5% and 5.2%, respectively. Conclusion: This prospective EL audit demonstrated low 30-day mortality with little interhospital variation. Individual hospitals have scope to improve their standards of care. The importance of prospective risk assessment is clear.

show abstract

Outcomes in emergency general surgery following the introduction of a consultant-led unit

Abstract: The establishment of a consultant-led emergency surgical service has been associated with improved provision of care, resulting in timely management and improved clinical outcomes.

Cited by 31 publications

References 40 publications

Mortality after emergency abdominal surgery in a non‐metropolitan Australian centre

Mortality after emergency abdominal surgery in a non‐metropolitan Australian centre

Multidisciplinary perioperative protocol in patients undergoing acute high-risk abdominal surgery

The Perth Emergency Laparotomy Audit

Contact Info

Product

Resources

About