Survival After Emergency Laparotomy in Octogenarians

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

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.

Study Overview

• Status: Completed
• Conditions: Postoperative Complications; Frailty; Surgery--Complications; Abdomen, Acute
• Intervention / Treatment: Other: No intervention

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 106

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 80 years and older (OLDER_ADULT)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients admitted to Haukeland University Hospital during 2015-2016

Description

Inclusion Criteria:

• emergency laparotomy in patients 80 years or above

Exclusion Criteria:

• palliative surgery
• abdominal surgery other than gastrointestinal
• abdominal surgery without midline incision

Study Plan

How is the study designed?

What is the study measuring?

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.

Collaborators and Investigators

• Sponsor: Haukeland University Hospital

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 1, 2015
• Primary Completion (ACTUAL): December 31, 2016
• Study Completion (ACTUAL): January 31, 2019

Study Registration Dates

• First Submitted: September 27, 2019
• First Submitted That Met QC Criteria: November 21, 2019
• First Posted (ACTUAL): November 25, 2019

Study Record Updates

• Last Update Posted (ACTUAL): November 25, 2019
• Last Update Submitted That Met QC Criteria: November 21, 2019
• Last Verified: November 1, 2019

More Information

Terms related to this study

• Keywords: Elderly; Postoperative complications; Frailty; Emergency surgery
• Additional Relevant MeSH Terms: Pathologic Processes; Pain; Neurologic Manifestations; Disease Attributes; Signs and Symptoms, Digestive; Abdominal Pain; Emergencies; Frailty; Postoperative Complications; Abdomen, Acute
• Other Study ID Numbers: 2017/610; REK 9526 (OTHER: Regional Ethics Committe)