Outcomes and associated factors among patients undergone emergency laparotomy: A retrospective study

Introduction: Emergency laparotomy patients are different in pathology and surgical urgency. Mortality rates following emergency laparotomy ranges from 13% to 18% which is five times greater than high-risk elective surgery. In addition, major complication rates are as high as 50%. Limited data is available in our country regarding outcomes of emergency laparotomy. This study aimed to assess outcome of emergency laparotomy. Objective: To determine outcomes and associated factors among patients undergone emergency laparotomy. Methods: A four years institutional based retrospective observational study was conducted for patients who undergone emergency laparotomy from January 2016 to January 2020.A total of 518 patient charts were enrolled in this study. All consecutive patient charts during the study period were included. Data was entered and analyzed using SPSS version 20. Descriptive statistics, cross-tabs and logistic regression analysis were performed to identify the association between dependant and independent variables. The strength of the association was presented using adjusted odds ratio with 95% confidence interval and p-value <= 0.05 was considered as statistically significant with mortality. Results: Mortality rate was 42 (8.1%) and 70(13.5%) patients were developed complication which needed surgical intervention under general anesthesia. The mean length of hospital stay was 8 +/- 5.9 days. Patients age >= 65 (AOR = 9.6, CI = 3.4-27.1), ASA status of >= III (AOR = 7.4, CI = 1.9-29.3), presence of preoperative sepsis (AOR = 6.7,(95% CI: 2.0-22.6) and intraoperative use of vasopressor (AOR = 10.5,(95% CI: 3.8-29.5) were significantly associated with mortality of emergency laparotomy patients. Conclusion: Emergency laparotomy possesses high mortality. Preoperative resuscitation and sepsis management may improve outcome following emergency laparotomy. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd.