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

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

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