Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study
Introduction: Emergency laparotomy (EL) is associated with high morbidity and mortality, often exceeding 10%. This study evaluated the impact of the EMergency Laparotomy Audit (EMLA) interdisciplinary perioperative pathway on patient outcomes, hospital costs and length of stay (LOS) within a single...
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Academy of Medicine Singapore
2024-12-01
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| Series: | Annals, Academy of Medicine, Singapore |
| Online Access: | https://annals.edu.sg/perioperative-emergency-laparotomy-pathway-for-patients-undergoing-emergency-laparotomy-a-propensity-score-matched-study/ |
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| author | Joel Wen Liang Lau Janardhan Baliga Faheem Khan Ying Xin Teo Jonathan Ming Jie Yeo Vincent Zhiwei Yeow Christine Xia Wu Stephanie Teo Tracy Jia Hui Goh Philip Iau Emergency Laparotomy Group |
| author_facet | Joel Wen Liang Lau Janardhan Baliga Faheem Khan Ying Xin Teo Jonathan Ming Jie Yeo Vincent Zhiwei Yeow Christine Xia Wu Stephanie Teo Tracy Jia Hui Goh Philip Iau Emergency Laparotomy Group |
| author_sort | Joel Wen Liang Lau |
| collection | DOAJ |
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Introduction: Emergency laparotomy (EL) is associated with high morbidity and mortality, often exceeding 10%. This study evaluated the impact of the EMergency Laparotomy Audit (EMLA) interdisciplinary perioperative pathway on patient outcomes, hospital costs and length of stay (LOS) within a single centre. Method: A prospective cohort study was conducted from August 2020 to July 2023. The intervention team included specialist clinicians, hospital administrators and an in-hospital quality improvement team. Patients who underwent EL were divided into a pre-intervention control group (n=136) and a post-intervention group (n=293), and an 8-item bundle was implemented. Propensity scoring with a 1:1 matching method was utilised to reduce confounding and selection bias. The primary outcomes examined were LOS, hospitalisation costs and surgical morbidity, while secondary outcomes included 30-day mortality and adherence to the intervention protocol. Results: The utilisation of the EMLA perioperative care bundle led to a significant reduction in surgical complications (34.8% to 20.6%, <P=0.01), a decrease in LOS by 3.3 days (15.4 to 12.1 days, P=0.03) and lower hospitalisation costs (SGD 40,160 to 30,948, P=0.04). Compliance with key interventions also showed improvement. However, there was no difference in 30-day mortality. Conclusion: This study offers insights on how surgical units can implement systemic perioperative changes to improve outcomes for patients undergoing emergency laparotomy. |
| format | Article |
| id | doaj-art-02dc5e71e08a422d9dc437c532583601 |
| institution | Kabale University |
| issn | 2972-4066 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Academy of Medicine Singapore |
| record_format | Article |
| series | Annals, Academy of Medicine, Singapore |
| spelling | doaj-art-02dc5e71e08a422d9dc437c5325836012025-01-13T03:04:38ZengAcademy of Medicine SingaporeAnnals, Academy of Medicine, Singapore2972-40662024-12-01531271372310.47102/annals-acadmedsg.2024311Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched studyJoel Wen Liang LauJanardhan BaligaFaheem KhanYing Xin TeoJonathan Ming Jie YeoVincent Zhiwei YeowChristine Xia WuStephanie TeoTracy Jia Hui GohPhilip IauEmergency Laparotomy Group Introduction: Emergency laparotomy (EL) is associated with high morbidity and mortality, often exceeding 10%. This study evaluated the impact of the EMergency Laparotomy Audit (EMLA) interdisciplinary perioperative pathway on patient outcomes, hospital costs and length of stay (LOS) within a single centre. Method: A prospective cohort study was conducted from August 2020 to July 2023. The intervention team included specialist clinicians, hospital administrators and an in-hospital quality improvement team. Patients who underwent EL were divided into a pre-intervention control group (n=136) and a post-intervention group (n=293), and an 8-item bundle was implemented. Propensity scoring with a 1:1 matching method was utilised to reduce confounding and selection bias. The primary outcomes examined were LOS, hospitalisation costs and surgical morbidity, while secondary outcomes included 30-day mortality and adherence to the intervention protocol. Results: The utilisation of the EMLA perioperative care bundle led to a significant reduction in surgical complications (34.8% to 20.6%, <P=0.01), a decrease in LOS by 3.3 days (15.4 to 12.1 days, P=0.03) and lower hospitalisation costs (SGD 40,160 to 30,948, P=0.04). Compliance with key interventions also showed improvement. However, there was no difference in 30-day mortality. Conclusion: This study offers insights on how surgical units can implement systemic perioperative changes to improve outcomes for patients undergoing emergency laparotomy.https://annals.edu.sg/perioperative-emergency-laparotomy-pathway-for-patients-undergoing-emergency-laparotomy-a-propensity-score-matched-study/ |
| spellingShingle | Joel Wen Liang Lau Janardhan Baliga Faheem Khan Ying Xin Teo Jonathan Ming Jie Yeo Vincent Zhiwei Yeow Christine Xia Wu Stephanie Teo Tracy Jia Hui Goh Philip Iau Emergency Laparotomy Group Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study Annals, Academy of Medicine, Singapore |
| title | Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study |
| title_full | Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study |
| title_fullStr | Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study |
| title_full_unstemmed | Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study |
| title_short | Perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy: A propensity score matched study |
| title_sort | perioperative emergency laparotomy pathway for patients undergoing emergency laparotomy a propensity score matched study |
| url | https://annals.edu.sg/perioperative-emergency-laparotomy-pathway-for-patients-undergoing-emergency-laparotomy-a-propensity-score-matched-study/ |
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