Outcomes of Emergency Laparotomy (EL) Care Protocol at Tertiary Care Center from Low–Middle‐Income Country (LMIC)

Abstract

LMIC centers should develop their own center-specific EL care protocols to improve outcomes of EL.

Outcome assessment of emergency laparotomies and associated factors in low resource setting. A case series

“…The factors that had strong association with postoperative morbidity were presence of preoperative co-morbidity ( P = 0.036), and bowel resection ( P = 0.002) [ 13 ]. The presence of co-morbidities and extensive operations like bowel resection where patients mostly develop bowel ischemia/gangrene are well known factors contributing for postoperative complications after emergency laparotomy [ 9 ].…”

“…EP is a resource-intensive surgical procedure with a high morbidity and mortality rates even in the best healthcare systems and remain an area of focus for quality improvement in developed nations [ [6] , [7] , [8] ]. Perioperative management of patients undergoing emergency laparotomy in middle and low-income countries is extremely challenging, and causes high postoperative 30-day patient morbidity and mortality as well as imposes a high healthcare cost burden [ 9 ]. Despite this, there is paucity of evidence on postoperative patient morbidity and mortality after emergency laparotomy in resource-limited settings which hamper the establishment of evidence-based optimal perioperative care bundle [ 9 ].…”

“…Perioperative management of patients undergoing emergency laparotomy in middle and low-income countries is extremely challenging, and causes high postoperative 30-day patient morbidity and mortality as well as imposes a high healthcare cost burden [ 9 ]. Despite this, there is paucity of evidence on postoperative patient morbidity and mortality after emergency laparotomy in resource-limited settings which hamper the establishment of evidence-based optimal perioperative care bundle [ 9 ]. In addition, in low-income countries, there are large volumes of emergency patients who need surgical care.…”

“…In addition, in low-income countries, there are large volumes of emergency patients who need surgical care. However, infrastructures such as operation rooms, advanced equipment, skilled human resources, investigation modalities such as Computerized tomography (CT) scan, Magnetic Resonance Imaging (MRI), Ultrasound (US) and drugs are limited [ 9 ]. Moreover, even with the available resources, there are variations in the preoperative patient optimization, surgical/anaesthetic quality care provision and utilization of the available resources all of which could negatively impact on postoperative patient outcome [ 9 ].…”

Psoas Attenuation and Mortality of Elderly Patients Undergoing Nontraumatic Emergency Laparotomy

“…1 EL carries further risk for postoperative mortality both in developed and underdeveloped countries reaching 8.8% 3 and 18.6%, respectively. 4 Proper patient management depends on recognition of reversible preoperative risk factors and unmodifiable risk. It is vital to recognize high-risk patients for appropriate resource planningdsuch as intensive care unit (ICU) admission and multidisciplinary caredduring the postoperative period.…”