A three-year retrospective analysis of variables and their relationships as outcome indicators following emergency laparotomies in octogenarians: insights from a single institutional experience

Authors

  • Altaf G. Haji Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Sadaf Zehra Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Mohamed Zohdy Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Najma Manzarai Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Abraham R. John Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Syed I. Haider Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Bala Piramanayagam Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Kalimuthu Marimuthu Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom
  • Selvam Lourdusamy Department of General and Gastrointestinal Surgery, George Elliot NHS Hospital, England, United Kingdom

DOI:

https://doi.org/10.18203/2349-2902.isj20240940

Keywords:

Octogenarians, Emergency laparotomy, National emergency laparotomy audit, Clinical frailty score

Abstract

Background: This retrospective study aims to specifically assess the morbidity and mortality outcomes linked to emergency laparotomies in a subset of patients aged 80 years and above, referred to as octogenarians. The objective is to gain insights into the specific challenges and outcomes faced by this elderly population undergoing emergency laparotomies.

Methods: This retrospective analysis focused on emergency laparotomies in octogenarians between June 2020 and June 2023, involving 62 cases out of 370 total emergency laparotomies conducted across various age groups. Using a standardized proforma, data was collected, and statistical analysis was performed with statistical package for the social sciences (SPSS).

Results: In this study involving 62 elderly patients (mean age 84) undergoing emergency laparotomies, common diagnoses included adhesional small bowel obstruction (32.3%)and large bowel obstruction due to diverticular disease (21.0%). Approximately 22.6% of cases were malignant, emphasizing the diverse nature of the cohort. A significant portion (56.5%) underwent bowel resection, and 16.1% had a stoma. Notably, 100% of patients were not seen by geriatrics, indicating potential gaps in comprehensive assessment despite the absence of geriatrician involvement, the overall mortality rate was 21%, emphasizing the potential impact of geriatrician reviews.

Conclusions: In summary, emergency major abdominal surgery poses significant risks, particularly for frail and elderly individuals with multiple co-morbidities. Recognizing frailty as an independent risk factor is crucial and highlights areas of potential improvement in this area with early involvement of geriatricians.

References

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Published

2024-04-09

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Original Research Articles