Comparative outcome analysis of trauma and non-trauma emergency laparotomy using a modified NELA tool format.
Journal
South African journal of surgery. Suid-Afrikaanse tydskrif vir chirurgie
ISSN: 2078-5151
Titre abrégé: S Afr J Surg
Pays: South Africa
ID NLM: 2984854R
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
entrez:
29
3
2021
pubmed:
30
3
2021
medline:
29
10
2021
Statut:
ppublish
Résumé
Emergency laparotomy (EL) encompasses a diverse range of procedures that general surgeons commonly perform for both trauma and non-trauma related conditions in South Africa (SA). Despite differences in the underlying pathology and influence of the surgical procedure, these patients share one care pathway for preoperative, operative and postoperative care. This study reviewed patients undergoing trauma EL and non-trauma EL in a general surgery setting at a rural KwaZulu-Natal tertiary hospital to compare results between the groups using a modified National Emergency Laparotomy Audit (NELA) tool format. Consecutive adult patients undergoing midline EL at Ngwelezana Hospital between 1 March and 31 May 2018 were included. Patient factors analysed were demographic data (age, gender) and risk factors: National Confidential Enquiry into Perioperative Deaths (NCEPOD) grade, American Society of Anesthesiologists (ASA) grade, and comorbidity. Process of care factors included grade of the physician, time to surgery, time of surgery and duration of surgery. The primary outcome measure was mortality. Secondary outcome measures were intensive care unit (ICU) admissions, complications, and length of stay (LOS) > 14 days. The study included 110 participants who met the inclusion criteria representing a total of 174 laparotomies. The trauma EL group had lower ASA grades ( The trauma EL group represents a high-risk group for morbidity and mortality at Ngwelezana Hospital.
Sections du résumé
BACKGROUND
BACKGROUND
Emergency laparotomy (EL) encompasses a diverse range of procedures that general surgeons commonly perform for both trauma and non-trauma related conditions in South Africa (SA). Despite differences in the underlying pathology and influence of the surgical procedure, these patients share one care pathway for preoperative, operative and postoperative care. This study reviewed patients undergoing trauma EL and non-trauma EL in a general surgery setting at a rural KwaZulu-Natal tertiary hospital to compare results between the groups using a modified National Emergency Laparotomy Audit (NELA) tool format.
METHODS
METHODS
Consecutive adult patients undergoing midline EL at Ngwelezana Hospital between 1 March and 31 May 2018 were included. Patient factors analysed were demographic data (age, gender) and risk factors: National Confidential Enquiry into Perioperative Deaths (NCEPOD) grade, American Society of Anesthesiologists (ASA) grade, and comorbidity. Process of care factors included grade of the physician, time to surgery, time of surgery and duration of surgery. The primary outcome measure was mortality. Secondary outcome measures were intensive care unit (ICU) admissions, complications, and length of stay (LOS) > 14 days.
RESULTS
RESULTS
The study included 110 participants who met the inclusion criteria representing a total of 174 laparotomies. The trauma EL group had lower ASA grades (
CONCLUSION
CONCLUSIONS
The trauma EL group represents a high-risk group for morbidity and mortality at Ngwelezana Hospital.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
12-19Informations de copyright
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