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Association between surgical delay and survival in high-risk emergency abdominal surgery. A population-based Danish cohort study.
- Source :
-
Scandinavian Journal of Gastroenterology . Jan2016, Vol. 51 Issue 1, p121-128. 8p. - Publication Year :
- 2016
-
Abstract
- Objective.In patients with perforated peptic ulcer, surgical delay has recently been shown to be a critical determinant of survival. The aim of the present population-based cohort study was to evaluate the association between surgical delay by hour and mortality in high-risk patients undergoing emergency abdominal surgery in general.Material and methods.All in-patients aged ≥18 years having emergency abdominal laparotomy or laparoscopy performed within 48 h of admission between 1 January 2009 and 31 December 2010 in 13 Danish hospitals were included. Baseline and clinical data, including surgical delay and 90-day mortality were collected. The crude and adjusted association between surgical delay by hour and 90-day mortality was assessed by binary logistic regression.Results.A total of 2803 patients were included. Median age (interquartile range [IQR]) was 66 (51–78) years, and 515 patients (18.4%) died within 90 days of surgery. Over the first 24 h after hospital admission, each hour of surgical delay beyond hospital admission was associated with a median (IQR) decrease in 90-day survival of 2.2% (1.9–3.3%). No statistically significant association between surgical delay by hour and 90-day mortality was shown; crude and adjusted odds ratio with 95% confidence interval 1.016 (1.004–1.027) and 1.003 (0.989–1.017), respectively. Sensitivity analyses confirmed the primary finding.Conclusions.In the present population-based cohort study of high-risk patients undergoing emergency abdominal surgery, no statistically significant adjusted association between mortality and surgical delay was found. Additional research in diagnosis-specific subgroups of high-risk patients undergoing emergency abdominal surgery is warranted. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00365521
- Volume :
- 51
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Scandinavian Journal of Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 110450816
- Full Text :
- https://doi.org/10.3109/00365521.2015.1066422