Survival After Emergency Laparotomy in Octogenarians

Study Overview
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Brief Summary
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In this single-center retrospective study we wanted to investigate mortality and postoperative complications after emergency laparotomy performed in patients aged 80 years or above.

Detailed Description
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Methods: During 2015-2016 106 patients aged 80 years or above underwent emergency laparotomy at Haukeland University Hospital. Primary outcome was mortality at 30 days. Secondary outcomes were mortality at 90 days, 1 year, postoperative complications and level of care at discharge. The Medical records were reviewed in detail and mortality and postoperative morbidity were registered. Post-operative complications were defined according to the European Perioperative Clinical Outcome (EPCO) definitions and included if they were Clavien Dindo grade 2 or above.

Official Title
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Mortality and Complications After Emergency Laparotomy in Patients 80 Years Old or Older

Conditions
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Abdomen, Acute, Surgery--Complications, Postoperative Complications, Frailty

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: emergency laparotomy in patients 80 years or above Exclusion Criteria: palliative surgery abdominal surgery other than gastrointestinal abdominal surgery without midline incision

Ages Eligible for Study
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Minimum Age: 80 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: No intervention|Retrospective observational study with no intervention|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Deaths within 30 days after emergency laparotomy | Mortality at 30 days after date of emergency laparotomy | From date of emergency laparotomy until 30 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Deaths within 90 days after emergency laparotomy | Mortality at 90 days after date of emergency laparotomy | 90 days after emergency laparotomy | 
| Number of Deaths within 1 year after emergency laparotomy | Mortality at 1 year after date of emergency laparotomy | 1 year after emergency laparotomy | 
| Postoperative complications | Number of patients having a postoperative complication as defined by the European Perioperative Clinical Outcome Definitions (EPCO) will be reported. The EPCO definitions state universal description of various common postoperative complications, like f.ex pulmonary complications, major adverse cardiac events, urinary tract infections and so on. This is a way of securing a universal approach to postoperative complications. We will grade complications according to the Clavien Dindo classification. According to this classification postoperative complications are graded from 1 to 5, where 1 indicates least severity of complication and 5 indicating worst severity. We will report number of patients having complications from grade 2 to grade 5. | Postoperative complications registered in medical records from date of emergency laparotomy until death in hospital or discharge from hospital, whichever came first. | 
| Level of care at discharge | From the medical records will be retreived information regarding dependency in activities of daily living (ADL) at discharge. Specifically will be measured number of patients discharged to own home, and number of patients discharged to nursing home facility. Also will be measured number of patients transferred to other hospital. | Up to 90 days from date of emergency laparotomy. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Emergency surgery, Frailty, Elderly, Postoperative complications