Current UK practice in emergency laparotomy

Barrow, E.; Anderson, ID; Varley, S.; Pichel, Adam; Peden, CJ; Saunders, D. A.; Murray, Dave

doi:10.1308/003588413x13629960048433

Cited by 38 publications

(41 citation statements)

References 14 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1][2][3][4][5] Our study highlighted the fact that several aspects of SS in SA differ from the experience in HICs. [12][13][14][15] The patient cohort is generally much younger than in HICs, as mean life expectancy is lower in SA. The most common SS is intra-abdominal sepsis, which is mainly secondary to acute appendicitis, followed by complicated peptic ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

The spectrum and outcome of surgical sepsis in Pietermaritzburg, South Africa

et al. 2017

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

The spectrum and outcome of surgical sepsis in Pietermaritzburg, South Africa

et al. 2017

View full text Add to dashboard Cite

“…Some, such as age, urgency of surgery and surgical pathology are less amenable to interventions that improve outcome [35,38]. Thirty-day mortality following emergency small bowel resection, for example, is 21% compared with 8.8% for emergency right hemicolectomy [39]. However, targeting other factors relating to the delivery of high-quality clinical care in a timely fashion, including haemorrhage and sepsis management, may yield improvements in postoperative mortality and morbidity.…”

Section: Discussionmentioning

confidence: 99%

Emergency surgery: the big three – abdominal aortic aneurysm, laparotomy and hip fracture

2013

View full text Add to dashboard Cite

SummaryNational reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely to rise as the population ages, this review summarises the evidence on which such guidance is based, and provides information about how anaesthetists might participate in audit and research aimed at improving local and national outcomes for these most vulnerable of patients. More recently, national audits have reported several-fold variations in the care of elderly emergency surgical patients in the UK [4][5][6], and importantly, these data are beginning to be used to drive quality improvement [11] through professional guidance [12][13][14] that advocates early, focused, multidisciplinary 70

show abstract

“…[1][2][3][4][5][6] It is defined as immediate emergency laparoscopy or laparotomy primarily to treat intestinal obstruction, perforated viscus or bowel ischemia. 7 A focus on enhanced recovery programs specifically for patients following AHA surgery is needed to improve the postoperative outcome.…”

mentioning

confidence: 99%

Physical performance following acute high-risk abdominal surgery: a prospective cohort study

Jønsson

Ingelsrud

Tengberg

et al. 2018

cjs

View full text Add to dashboard Cite

Background: Acute high-risk abdominal (AHA) surgery is associated with high mortality, multiple postoperative complications and prolonged hospital stay. Further development of strategies for enhanced recovery programs following AHA surgery is needed. The aim of this study was to describe physical performance and barriers to independent mobilization among patients who received AHA surgery (postoperative days [POD] 1-7). Methods:Patients undergoing AHA surgery were consecutively enrolled from a university hospital in Denmark. In the first postoperative week, all patients were evaluated daily with regards to physical performance, using the Cumulated Ambulation Score (CAS; 0-6 points) to assess basic mobility and the activPAL monitor to assess the 24-hour physical activity level. We recorded barriers to independent mobilization.Results: Fifty patients undergoing AHA surgery (mean age 61.4 ± 17.2 years) were included. Seven patients died within the first postoperative week, and 15 of 43 (35%) patients were still not independently mobilized (CAS < 6) on POD-7, which was associated with pulmonary complications developing (53% v. 14% in those with CAS = 6, p = 0.012). The patients lay or sat for a median of 23.4 hours daily during the first week after AHA surgery, and the main barriers to independent mobilization were fatigue and abdominal pain. Conclusion:Patients who receive AHA surgery have very limited physical performance in the first postoperative week. Barriers to independent mobilization are primarily fatigue and abdominal pain. Further studies investigating strategies for early mobilization and barriers to mobilization in the immediate postoperative period after AHA surgery are needed.Contexte : La chirurgie abdominale d'urgence à risque élevé est associée à un fort taux de mortalité, à des complications postopératoires multiples et à des hospitalisations prolongées. Il est donc nécessaire d'élaborer de nouvelles stratégies pour amélio-rer le rétablissement après ce type de chirurgie. La présente étude visait à décrire le fonctionnement physique et les obstacles aux déplacements autonomes chez les patients ayant subi une chirurgie de ce type (jours postopératoires 1 à 7).Méthodes : Nous avons recruté successivement les patients subissant une chirurgie abdominale d'urgence à risque élevé dans un hôpital universitaire du Danemark. Durant la première semaine postopératoire, tous les patients ont subi quotidiennement une évaluation visant à vérifier leur fonctionnement physique. Nous nous sommes servis du Cumulated Ambulation Score (CAS; de 0 à 6 points) pour évaluer la mobilité de base et du moniteur activPAL pour évaluer le niveau d'activé physique 24 heures par jour. Nous avons noté les obstacles aux déplacements autonomes.Résultats : Cinquante patients (âge moyen : 61,4 ans ± 17,2) ont été retenus. Sept sont décédés durant la première semaine postopératoire, et 15 des 43 patients restants (35 %) ne se déplaçaient pas encore de façon autonome (CAS < 6) le septième jour, une situation associée à l'apparition de c...

show abstract

Current UK practice in emergency laparotomy

Cited by 38 publications

References 14 publications

The spectrum and outcome of surgical sepsis in Pietermaritzburg, South Africa

The spectrum and outcome of surgical sepsis in Pietermaritzburg, South Africa

Emergency surgery: the big three – abdominal aortic aneurysm, laparotomy and hip fracture

Physical performance following acute high-risk abdominal surgery: a prospective cohort study

Contact Info

Product

Resources

About