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Best Abstracts - Runner-up Session 1

High mortality following emergency gastrointestinal surgery: a cohort study

ESAAP1-6

Vester-Andersen, M.; Lundstrøm, L. H.; Waldau, T.; Møler, M. H.; Møller, A. M. The Danish Anaesthesia Database

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European Journal of Anaesthesiology (EJA): June 2013 - Volume 30 - Issue - p 4-5
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Background: Emergency gastrointestinal surgery is common, but with few outcome data. We aimed to determine the 30-day mortality rate in a consecutive Danish cohort.

Methods: A total of 4920 adult patients undergoing emergency laparotomy or laparoscopic surgery, from January 1, 2009, to December 31, 2010, in 13 Danish gastrointestinal surgery departments were included. Patients undergoing appendectomy or negative diagnostic laparoscopy were excluded. The appropriate surgical procedure codes were retrieved from The National Patient Register (NPR) and matched to data from the Danish Anaesthesia Database (DAD) by The Civil Registry Number. If a patient was registered with more than one emergency procedure, only the first procedure was included in the analysis. Surgical priority (emergency or planned) and ASA score were registered in the Danish Anaesthesia Database perioperatively. The primary outcome measure, 30-day mortality, was retrieved from The Danish Civil Registration system.

[Table 2: 30-day mortality data - subgroups]

Results: We retrieved 14.719 procedures from The NPR of which 93.4% were matched to DAD perioperative data. Altogether 4.920 eligible patients were undergoing emergency procedures in the period (table 1). The all-cause 30-day mortality was 18.0 % (C.I. 16.9 - 19.1). A total of 65.9 % of the patients were above 60 years. Furthermore 47.5 % of the patients had a severe systemic disease pre-operatively (ASA score 3 or above) with a 30-day mortality rate of 31.7 % (C.I. 29.8 - 33.6).

[Table 1: Flow-chart of study cohort selection]

Conclusion: Emergency gastrointestinal surgery has a high 30-day mortality rate. This high-risk group comprises patients of advanced age and with significant co-existent diseases.

Acknowledgements: Jacob Rosenberg

© 2013 European Society of Anaesthesiology