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.

译文

背景:“急诊开放性腹部手术”一词涵盖了一系列常见手术,具有很高的并发症和死亡风险;但是,以前的研究并未包括对接受手术的患者的描述性分析。这项研究的目的是对在丹麦医院进行了紧急肠切除,造口术或引流手术的所有患者进行全民描述,并报告30天和365天的死亡风险。
方法:我们在丹麦国家患者登记簿中确定了所有18岁以下的患者,这些患者在2003-14年期间以剖腹手术的形式接受了紧急的开放式腹部手术。使用泊松和逻辑回归模型,我们分析了发病率和死亡风险。
结果:该样本包括15680例患者,总体开放性腹部手术的发生率为每10万人年30.4例。男女的30天死亡风险为19.3%,并且随着年龄的增长而增加(在80-89岁时,男性的死亡风险为39.4%,女性为34.5%)。在研究期间,30天的死亡率降低了5.4%,从22.2%降低到16.7%。
结论:开腹手术是一种常见的高风险手术,具有较高的发病率和死亡风险,特别是对于老年患者。在研究期间,发病率和死亡风险下降。在丹麦,没有针对急诊剖腹手术的患者的标准出院后护理计划。我们的结果支持需要研究标准化的术后随访和康复计划以降低死亡率。

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