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Implementation of a multidisciplinary perioperative protocol in major emergency abdominal surgery

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Enhanced recovery after surgery programs is widely implemented in elective settings, however, until recently, rarely in emergency surgery. The purpose of this study was to present detailed contents and data on implementation of an emergency abdominal perioperative protocol on the basis of compliance.

Methods

A multidisciplinary perioperative bundle for major emergency abdominal surgery was developed and implemented in March 2017 covering surgical, emergency, anesthesiological, radiological, physiotherapy, and nutritional support. The bundle consisted of preoperative-, intraoperative-, and postoperative initiatives. Fifteen core protocol items were identified for audit and compliance rates for each protocol item and overall compliance rates were evaluated and quarterly stratified throughout the first year of implementation.

Results

A total of 227 consecutive patients underwent major emergency abdominal surgery from March 2017 throughout February 2018. The specific protocol items showed high individual compliance rates throughout all quarters of the first year. Time to suspicion of diagnosis at the emergency department, rate of perioperative thoracic epidural, and postoperative referral to physiotherapy showed the lowest compliance rates. The overall compliance rate of all 15 protocol items was 83% (min–max 71.4–100%).

Conclusion

We found it possible to implement a comprehensive detailed perioperative protocol in emergency abdominal surgery across multiple specialties with an overall good compliance of protocol items.

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Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Department of Surgery, Centre for Surgical Science, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark

    Jakob Burcharth, Sarah Ekeloef, Thomas Jørgensen & Ismail Gögenur

  2. Department of Radiology, Zealand University Hospital, Koege, Denmark

    Luka Abdulhady

  3. Department of Anesthesiology, Centre of Anaesthesiological Research, Zealand University Hospital, Koege, Denmark

    Jakob Danker, Thomas Bech Lunen & Ole Mathiesen

  4. Department of Emergency Medicine, Zealand University Hospital, Koege, Denmark

    Halfdan Lauridsen

  5. Department of Medicine and Nutrition, Zealand University Hospital, Koege, Denmark

    Malene Lyngesen

  6. Department of Physiotherapy, Zealand University Hospital, Koege, Denmark

    Iben Puggaard

  7. Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

    Ole Mathiesen

Authors
  1. Jakob Burcharth
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  2. Luka Abdulhady
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  3. Jakob Danker
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  4. Sarah Ekeloef
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  5. Thomas Jørgensen
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  6. Halfdan Lauridsen
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  7. Thomas Bech Lunen
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  8. Malene Lyngesen
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  9. Iben Puggaard
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  10. Ole Mathiesen
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  11. Ismail Gögenur
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Corresponding author

Correspondence to Jakob Burcharth.

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Conflict of interest

All authors declare no conflicts of interest.

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Burcharth, J., Abdulhady, L., Danker, J. et al. Implementation of a multidisciplinary perioperative protocol in major emergency abdominal surgery. Eur J Trauma Emerg Surg 47, 467–477 (2021). https://doi.org/10.1007/s00068-019-01238-7

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  • DOI: https://doi.org/10.1007/s00068-019-01238-7

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