Long-term Outcomes After Emergency Laparotomy: a Retrospective Study

被引:11
作者
Ylimartimo, Aura T. [1 ,2 ]
Lahtinen, Sanna [1 ,3 ]
Nurkkala, Juho [1 ,3 ]
Koskela, Marjo [1 ,2 ]
Kaakinen, Timo [1 ,3 ]
Vakkala, Merja [1 ,3 ]
Hietanen, Siiri [1 ]
Liisanantti, Janne [1 ,3 ]
机构
[1] Med Res Ctr Oulu, Res Grp Surg Anesthesiol & Intens Care Med, Oulu, Finland
[2] Oulu Univ Hosp, Dept Surg, POB 21, Oulu 90029, Finland
[3] Oulu Univ Hosp, Dept Anesthesiol, Oulu, Finland
关键词
Emergency laparotomy; Long-term outcomes; Mortality; QUALITY-OF-LIFE; POSTOPERATIVE COMPLICATIONS; MORTALITY; SURGERY; MORBIDITY; SCORE;
D O I
10.1007/s11605-022-05372-3
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Emergency laparotomy (EL) is a common surgical operation with poor outcomes. Patients undergoing EL are often frail and have chronic comorbidities, but studies focused on the long-term outcomes after EL are lacking. The aim of the present study was to examine the long-term mortality after EL. Methods We conducted a retrospective single-center cohort study of 674 adults undergoing midline EL between May 2015 and December 2017. The follow-up lasted until September 2020. The primary outcome was 2-year mortality after surgery. The secondary outcome was factors associated with mortality during follow-up. Results A total of 554 (82%) patients survived > 90 days after EL and were included in the analysis. Of these patients, 120 (18%) died during the follow-up. The survivors were younger than the non-survivors (median [IQR] 64 [49-74] vs. 71 [63-80] years, p < 0.001). In a Cox regression model, death during follow-up was associated with longer duration of operation (OR 2.21 [95% CI 1.27-3.83]), higher ASA classification (OR 2.37 [1.15-4.88]), higher CCI score (OR 4.74 [3.15-7.14]), and postoperative medical complications (OR 1.61 [1.05-2.47]). Conclusions Patient-related factors, such as higher ASA classification and CCI score, were the most remarkable factors associated with poor long-term outcome and mortality after EL.
引用
收藏
页码:1942 / 1950
页数:9
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