Navigation Links
Study reveals major funding shortfall and high death rates for emergency laparotomy
Date:4/18/2012

Anaesthetists have identified a major shortfall in funding for emergency laparotomies in England and have called for a national database to establish a more accurate picture of outcomes and costs. Figures published in the May issue of Anaesthesia suggest a shortfall of 300 million per year for emergency midline general surgical laparotomies, 32% of the total cost of care.

The study also found that emergency laparotomy, which involves a large midline incision in the abdomen, had a high death rate, with 14% of patients dying in hospital and a further 11% dying within 30 days of surgery. Patients over 70 years of age were three times as likely to die as patients under 70.

"There has been considerable interest in trying to improve surgical outcomes after emergency operations, particularly among sick, elderly patients" says Dr Stuart M White, Consultant Anaesthetist at the Royal Sussex County Hospital, Brighton, UK.

"Although there has been recent political and professional attention focused on the management of hip fractures, there has been relatively little interest specifically aimed at improving the management of elderly patients undergoing emergency laparotomy, despite the costs involved and the effect this operation has on patients' lives. This will hopefully improve with the recent formation of the Emergency Laparotomy Network by the Age Anaesthesia Association."

The authors studied 768 patients who had received emergency laparoscopy surgery between 2009 and 2010 in order to estimate the annual incidence of emergency laparotomy in England and whether there was adequate funding for the number of procedures carried out. They were also keen to analyse age-related death rates from the emergency procedure and the cost differences between younger and older patients undergoing the procedure.

All patients who underwent emergency midline laparotomy for a general surgical procedure were included. However patients undergoing emergency appendicectomy, vascular, endoscopic and gynaecological procedures were excluded, unless these were performed as coincidental surgery.

Key findings of the study include:

  • 768 patients underwent 850 emergency laparotomies, an average incidence of one emergency procedure per 1,082 patients, in line with Government figures for the period. The most common procedures were bowel surgery, accounting for 34% of the total.

  • 21% of the operations were carried out on the day of admission and 39% out-of-hours (between 5pm and 8am). Median operating time was three hours and 36% of patients were admitted to the critical care unit, where they stayed for a median of five days. The median post-operative hospital stay was 13 days.

  • The patients ranged from 16 to 102 years of age, with a median age of 68, and 46% were 70 years or more. These older patients were three times as likely to die in hospital after surgery than patients under 70 (21% versus 7%) and three times as likely to die within 30 days of surgery (18% versus 6%). They also stayed in hospital longer.

  • The average cost of an inpatient stay with emergency laparotomy was 13,000, more than 6,000 higher than the amount the hospital was paid for each patient. This was equivalent to an estimated shortfall of 300 million across the National Health Service in England.

"We believe that our study supports the need for a national database of emergency laparotomies, similar to the one established for hip fractures in the UK" says Dr White.

"The National Hip Fracture Database has collected data on more than 130,000 cases over the last four years and is already providing an immensely powerful audit tool. By highlighting variations in clinical and organisational quality it will enable us to learn from hospitals that perform well and help hospitals that do not perform as well.

"In the absence of a similar database for emergency laparotomies, we would urge anaesthetists to collect and analyse data from their own hospital and contribute to the Emergency Laparotomy Network established by the Age Anaesthesia Association."


'/>"/>

Contact: Annette Whibley
annette.wizard@gmail.com
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Despite Treatment, Employees with Depression Generate Higher Absentee Costs, According to Thomson Reuters Study
2. American Council on Exercise (ACE) Study Reveals Kettlebells Provide Powerful Workout in Short Amount of Time
3. TV drama can be more persuasive than news program, study finds
4. Study carried out into biological risks of eating reptiles
5. Neuroimaging study may pave way for effective Alzheimers treatments
6. Study finds racial gaps continue in heart disease awareness
7. Luth Researchs IndicatorEDG(TM) Study Finds Americans Hopes of Achieving Their Dreams Are Fading
8. First blinded study of venous insufficiency prevalence in MS shows promising results
9. Soothing infants with food focus of childhood obesity study
10. People with anxiety disorder less able to regulate response to negative emotions, study shows
11. American Heart Association Rapid Access Journal Report: Study Finds Racial Gaps Continue in Heart Disease Awareness, Low Knowledge of Heart Attack Warning Signs Among Women
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/25/2016)... (PRWEB) , ... June 25, 2016 , ... First ... United States, named Dr. Sesan Ogunleye, as the Medical Director of its new Mesquite-Samuell ... facility Medical Director of our new Mesquite location,” said Dr. James M. Muzzarelli, Executive ...
(Date:6/25/2016)... Oklahoma City, Oklahoma (PRWEB) , ... June 25, ... ... to helping both athletes and non-athletes recover from injury. Recently, he has implemented ... for the Oklahoma City area —Johnson is one of the first doctors to ...
(Date:6/25/2016)... ... 2016 , ... Conventional wisdom preaches the benefits of moderation, whether it’s a ... the bar too high can result in disappointment, perhaps even self-loathing. However, those who ... , Research from PsychTests.com reveals that behind the tendency to set ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events ... turn to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. ... tools for healthy coping following a traumatic event. , Trauma sufferers tend to feel ...
(Date:6/24/2016)... ... ... a crisis. Her son James, eight, was out of control. Prone to extreme mood shifts ... upset him, he couldn’t control his emotions,” remembers Marcy. “If there was a knife ... and say he was going to kill them. If we were driving on the ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 ... Tomorrow,s Leaders Scholarship is any indication, the future is ... online at www.diabetesscholars.org by the Diabetes Scholars ... in the way of academic and community service excellence. ... program since 2012, and continues to advocate for people ...
(Date:6/23/2016)... 2016 Revolutionary technology includes multi-speaker ... , industry leaders in advanced audiology and hearing aid ... Opn ™, the world,s first internet connected hearing aid ... devices.      (Photo: http://photos.prnewswire.com/prnh/20160622/382240 ) ... of ,world firsts,: , TwinLink™ - the ...
(Date:6/23/2016)... 23, 2016 The vast majority of dialysis ... facility.  Treatments are usually 3 times a week, with ... including travel time, equipment preparation and wait time.  This ... grueling for patients who are elderly and frail.  Many ... and rehabilitation centers for some duration of time. ...
Breaking Medicine Technology: