Emergency Laparotomy in Denmark: A Nationwide Descriptive Study

World J Surg. 2020 Sep;44(9):2976-2981. doi: 10.1007/s00268-020-05580-5.

Abstract

Background: The term 'emergency open abdominal surgery' covers a range of common procedures with high complication and mortality risks; however, previous studies have not included descriptive analyses of the patients undergoing the procedures. The aim of this study is to present a nationwide description of all patients who undergo an emergency bowel resection, ostomy placement or drainage involving laparotomy at Danish hospitals and to report the 30- and 365-day mortality risks.

Method: We identified all of the patients in the Danish National Patient Register aged 18 + who underwent emergency open abdominal surgery in the form of a laparotomy during the period 2003-14. Using Poisson and logistic regression models, we analyzed incidence rates and mortality risk.

Result: The sample consisted of 15,680 patients, with an overall open abdominal surgery incidence rate of 30.4 cases per 100,000 person-years. The 30-day mortality risk was 19.3% for both sexes, and increased with age (at 80-89, mortality risk was 39.4% for males and 34.5% for females). The 30-day mortality risk fell by 5.4% during the study period, from 22.2% to 16.7%.

Conclusion: Open abdominal surgery is a common, high-risk procedure with a high incidence rate and mortality risk, especially for elderly patients. The incidence rate and mortality risk fell during the period studied. In Denmark, there is no standard post-discharge care program for patients who undergo emergency laparotomies. Our results support the need to investigate standardized post-operative follow-up and rehabilitation plans to reduce mortality.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery*
  • Adolescent
  • Adult
  • Aftercare
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Laparotomy / mortality
  • Laparotomy / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Young Adult