Copenhagen University Hospital, Hvidovre, Denmark.
Copenhagen University Hospital, Køge, Denmark.
Anaesthesia. 2017 Mar;72(3):309-316. doi: 10.1111/anae.13721. Epub 2016 Nov 3.
Mortality and morbidity occur commonly following emergency laparotomy, and incur a considerable clinical and financial healthcare burden. Limited data have been published describing the postoperative course and temporal pattern of complications after emergency laparotomy. We undertook a retrospective, observational, multicentre study of complications in 1139 patients after emergency laparotomy. A major complication occurred in 537/1139 (47%) of all patients within 30 days of surgery. Unadjusted 30-day mortality was 20.2% and 1-year mortality was 34%. One hundred and thirty-seven of 230 (60%) deaths occurred between 72 h and 30 days after surgery; all of these patients had complications, indicating that there is a prolonged period with a high frequency of complications and mortality after emergency laparotomy. We conclude that peri-operative, enhanced recovery care bundles for preventing complications should extend their focus on continuous complication detection and rescue beyond the first few postoperative days.
术后并发症发生率和病死率在急诊剖腹术后较为常见，给临床和医疗保健带来了相当大的负担。目前仅有少量数据描述了急诊剖腹术后的术后病程和并发症的时间模式。我们对 1139 例急诊剖腹术后患者的并发症进行了回顾性、观察性、多中心研究。在术后 30 天内，所有患者中有 537/1139（47%）发生了主要并发症。未调整的 30 天病死率为 20.2%，1 年病死率为 34%。230 例死亡病例中有 137 例（60%）发生在术后 72 小时至 30 天内；所有这些患者都有并发症，这表明在急诊剖腹术后存在一个并发症和病死率高发且持续时间长的阶段。我们得出结论，预防并发症的围手术期、强化康复护理包应将其对并发症的持续检测和抢救的关注范围扩大到术后的最初几天之外。
