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Emergency Laparotomy in Denmark: A Nationwide Descriptive Study

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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.

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References

  1. Edwards AE, Seymour DG, McCarthy JM, Crumplin MKH (1996) A 5-year survival study of general surgical patients aged 65 years and over. Anaesthesia 51:3–10

    Article  CAS  PubMed  Google Scholar 

  2. Leppäniemi AK (2010) Laparostomy: why and when? Crit Care 14:216

    Article  PubMed  PubMed Central  Google Scholar 

  3. Saunders DI, Murray D, Pichel AC, Varley S, Peden CJ (2012) Variations in mortality after emergency laparotomy: the first report of the UK Emergency Laparotomy Network. Br J Anaesth 109(3):368–375

    Article  CAS  PubMed  Google Scholar 

  4. Barrow E, Anderson I, Varley S, Pichel A, Peden C, Saunders D et al (2013) Current UK practice in emergency laparotomy. Ann R Coll Surg Engl 95:599–603

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Team NP (2017) Third patient report of the national emergency laparotomy audit. London 2017

  6. Iversen L, Green A, Ingeholm P, Østerlind L, Gögenur I (2016) Improved survival of colorectal cancer in Denmark during 2001–2012: the efforts of several national initiatives. Acta Oncol 55(2):10–23

    Article  PubMed  Google Scholar 

  7. Tengberg L, Bay-Nielsen M, Bisgaard T, Cihoric M, Lauritsen M, Foss N et al (2017) Multidisciplinary perioperative protocol in patients undergoing acute high-risk abdominal surgery. Br J Surg 104(4):463–471

    Article  CAS  PubMed  Google Scholar 

  8. Lynge E, Sandegaard JL, Rebolj M (2011) The Danish national patient register. Scand J Public Health 39(7):30–33

    Article  PubMed  Google Scholar 

  9. Pedersen CB (2011) The Danish civil registration system. Scand J Public Health 39(7):22–25

    Article  PubMed  Google Scholar 

  10. Thygesen SK, Christiansen CF, Christensen S, Lash TL, Sørensen HT (2011) The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish national registry of patients. BMC Med Res Methodol 11:83

    Article  PubMed  PubMed Central  Google Scholar 

  11. Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 40(5):373–383

    Article  CAS  PubMed  Google Scholar 

  12. FOLK1A: Folketal den 1. i kvartalet efter omraade, koen, alder og civilstand. [Internet]. Danmarks Statistik. [n.d] [cited 02.06.2018]. Danmarks Statistik - www.statistikbanken.dk/FOLK1A

  13. Al-Temimi MH, Griffee M, Enniss TM, Preston R, Vargo D, Overton S et al (2012) When is death inevitable after emergency laparotomy? analysis of the american college of surgeons national surgical quality improvement program database. J Am Coll Surg 215(4):503–511

    Article  PubMed  Google Scholar 

  14. Clarke A, Murdoch H, Thomas MJ, Cook TM, Peden CJ (2011) Mortality and postoperative care after emergency laparotomy. Eur Soc Anaesthesiol 28(1):7–9

    Article  Google Scholar 

  15. Jeppesen MH, Tolstrup M-B, Watt SK, Gögenur I (2016) Risk factors affecting morbidity and mortality following emergency laparotomy for small bowel obstruction: a retrospective cohort study. Int J Surg. 28:63–68

    Article  PubMed  Google Scholar 

  16. Tolstrup MB, Watt SK, Gogenur I (2017) Morbidity and mortality rates after emergency abdominal surgery: an analysis of 4346 patients scheduled for emergency laparotomy or laparoscopy. Langenbecks Arch Surg. 402(4):615–623

    Article  PubMed  Google Scholar 

  17. Scott JW, Olufajo OA, Brat GA, Rose JA, Zogg CK, Haider AH et al (2016) Use of national burden to define operative emergency general Surgery. JAMA Surg 151(6):e160480–e160480

    Article  PubMed  Google Scholar 

  18. Fukuda N, Wada J, Niki M, Sugiyama Y, Mushiake H (2012) Factors predicting mortality in emergency abdominal surgery in the elderly. World J Emerg Surg. 7(1):12

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ingraham AM, Cohen ME, Bilimoria KY, Raval MV, Ko CY, Nathens AB et al (2010) Comparison of 30-day outcomes after emergency general surgery procedures: potential for targeted improvement. Surgery 148(2):217–238

    Article  PubMed  Google Scholar 

  20. Kjærgaard J, Clemmensen IH, Thomsen BL, Storm HH (2002) Validity of diagnoses of and operations for nonmalignant gynecological conditions in the Danish national hospital registry. J Clin Epidemiol 55(2):137–142

    Article  PubMed  Google Scholar 

  21. Holte K, Bay-Nielsen M, Utzon J, Støckel M, Funch-Jensen P, Kehlet H (2001) Gastroesophageal reflux surgery in Denmark 1997-1999. Ugeskr Laeger 163(41):5658–5661

    CAS  PubMed  Google Scholar 

  22. Harboe KM, Anthonsen K, Bardram L (2009) Validation of data and indicators in the Danish Cholecystectomy Database. Int J Qual Health Care 21(3):160–168

    Article  PubMed  Google Scholar 

  23. Kleif J, Thygesen LC, Gögenur I (2018) Validity of the diagnosis of appendicitis in the Danish national patient register. Scand J Public Health 48:1–5

    Google Scholar 

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Acknowledgements

The authors would like to thank Dr Thomas Jørgensen for the selecting the surgical codes.

Funding

The funding sources had no influence on study design, data collection, analysis, manuscript preparation or publication. The study received grants from Frimodt-Heinecke fonden, and Fabrikant Frands Køhler Nielsens and Hustrus mindelegat.

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Authors and Affiliations

  1. National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark

    Mie S. Liljendahl & Lau C. Thygesen

  2. Department of Surgery, Zealand University Hospital, Køge, Denmark

    Ismail Gögenur

  3. Center for Surgical Sciences, Department of Surgery and Institute of Clinical Medicine, Zealand University Hospital and Copenhagen University, Copenhagen, Denmark

    Ismail Gögenur

Authors
  1. Mie S. Liljendahl
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  2. Ismail Gögenur
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  3. Lau C. Thygesen
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Corresponding author

Correspondence to Lau C. Thygesen.

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The authors declare that they have no conflict of interests.

Informed consent

According to Danish law, it is not necessary to obtain informed consent from patients when utilizing data that is exclusively register-based.

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Liljendahl, M.S., Gögenur, I. & Thygesen, L.C. Emergency Laparotomy in Denmark: A Nationwide Descriptive Study. World J Surg 44, 2976–2981 (2020). https://doi.org/10.1007/s00268-020-05580-5

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  • DOI: https://doi.org/10.1007/s00268-020-05580-5

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