Abstract:
Background: Emergency laparotomy is a high risk procedure which is demonstrated by high morbidity and
mortality. However, the problem is tremendous in resource limited settings and there is limited data on patient
outcome. We aimed to assess postoperative patient outcome after emergency laparotomy and associated factors.
Methods: An observational study was conducted in our hospital from March 11- June 30, 2015 using emergency
laparotomy network tool. All consecutive surgical patients who underwent emergency laparotomy were included. Binary and multiple logistic regressions were employed using adjusted odds ratios and 95% CI, and Pvalue < 0.05 was considered to be statistically significant.
Result: A total of 260 patients were included in the study. The majority of patients had late presentation
(> 6hrs) to the hospital after the onset of symptoms of the diseases and surgical intervention after hospital
admission. The incidences of postoperative morbidity and mortality were 39.2% and 3.5% respectively. Factors
associated with postoperative morbidity were preoperative co-morbidity (AOR = 0.383, CI = 0.156–0.939) and
bowel resection (AOR = 0.232, CI = 0.091–0.591). Factors associated with postoperative mortality were anesthetists' preoperative opinion on postoperative patient outcome (AOR = 0.067, CI = 0.008–0.564), level of
consciousness during recovery from anaesthesia (AOR = 0.114, CI = 0.021–10.628) and any re-intervention
within 30 days after primary operation (AOR = 0.083, CI = 0.009–0.750).
Conclusion and recommendation: The incidence of postoperative morbidity and mortality after emergency laparotomy were high. We recommend preoperative optimization, early surgical intervention, and involvement of
senior professionals during operation in these risky surgical patients. Also, we recommend the use of WHO or
equivalent Surgical Safety Checklist and establishment of perioperative patient care bundle including surgical
ICU and radiology investigation modalities such as CT scan.
