Saunders D I, Sinclair R C F, Griffiths B, Pugh E, Harji D, Salas B, Reed H, Scott C
Department of Anaesthesia, Royal Victoria Infirmary, Newcastle upon Tyne, NHS FT, NE1 4LP, UK.
Department of Colorectal Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, NHS FT, NE1 4LP, UK.
Perioper Med (Lond). 2021 Jul 26;10(1):22. doi: 10.1186/s13741-021-00193-5.
Emergency laparotomy carries a significant risk profile around the time of surgery. This research aimed to establish the feasibility of recruitment to a study using validated scoring tools to assess complications after surgery; and patient-reported outcome measures (PROMs) to assess quality of life and quality of recovery up to a year following emergency laparotomy (EL).
We used our local National Emergency Laparotomy Audit (NELA) register to identify potential participants at a single NHS centre in England. Complications were assessed at 5, 10 and 30 days after EL. Patient-reported outcome measures were collected at 1, 3, 6 and 12 months after surgery using EQ5D and WHODAS 2.0 questionnaires.
Seventy of 129 consecutive patients (54%) agreed to take part in the study. Post-operative morbidity survey data was recorded from 63 and 37 patients at postoperative day 5 and day 10. Accordion Complication Severity Grading data was obtained from 70 patients. Patient-reported outcome measures were obtained from patients at baseline and 1, 3, 6 and 12 months after surgery from 70, 59, 51, 48, to 42 patients (100%, 87%, 77%, 75% and 69% of survivors), respectively.
This study affirms the feasibility of collecting PROMs and morbidity data successfully at various time points following emergency laparotomy, and is the first longitudinal study to describe quality of life up to a year after surgery. This finding is important in the design of a larger observational study into quality of life and recovery after EL.
急诊剖腹手术在手术期间存在重大风险。本研究旨在确定使用经过验证的评分工具评估术后并发症以及使用患者报告结局指标(PROMs)评估急诊剖腹手术(EL)后长达一年的生活质量和恢复质量的研究招募的可行性。
我们使用当地的国家急诊剖腹手术审计(NELA)登记册在英格兰的一个NHS中心识别潜在参与者。在EL术后5天、10天和30天评估并发症。使用EQ5D和WHODAS 2.0问卷在术后1个月、3个月、6个月和12个月收集患者报告结局指标。
129例连续患者中有70例(54%)同意参加研究。在术后第5天和第10天分别从63例和37例患者记录了术后发病率调查数据。从70例患者获得了手风琴并发症严重程度分级数据。分别从70例、59例、51例、48例至42例患者(分别占幸存者的100%、87%、77%、75%和69%)在基线以及术后1个月、3个月、6个月和12个月获得了患者报告结局指标。
本研究证实了在急诊剖腹手术后不同时间点成功收集PROMs和发病率数据的可行性,并且是第一项描述术后长达一年生活质量的纵向研究。这一发现对于设计一项关于EL后生活质量和恢复情况的更大规模观察性研究具有重要意义。