Elderly Patients’ Outcomes following Emergency Laparotomy—Early Surgical Consultations Are Crucial

• Published in: Surgeries Vol. 5; no. 2; pp. 115 - 124
• Main Authors: Gefen, Rachel, Abu Salem, Samer, Kedar, Asaf, Gottesman, Joshua Zev, Marom, Gad, Pikarsky, Alon J., Bala, Miklosh
• Format: Journal Article
• Language: English
• Published: MDPI AG 01.06.2024
• Subjects: admitting service; discharge destination; elderly; emergency laparotomy
• ISSN: 2673-4095; 2673-4095
• DOI: 10.3390/surgeries5020013

We aimed to study the relationship between mortality following emergency laparotomy (EL) in elderly patients and admission to a hospital facility, hypothesizing that patients initially admitted to a general surgery service have a better outcome. A retrospective review of the medical records of all the elderly patients (≥65 years) who underwent EL over three years was conducted in a single tertiary medical center. The outcomes evaluated include postoperative morbidity, mortality, discharge destination, and readmission. A total of 200 patients were eligible for this study; 106 (53%) were male, with a mean age of 77 ± 8.3 years. The mortality rate was 29.5% (59 patients), and 55% of all patients were discharged home after initial admission. Bowel obstruction was the most common indication for surgery (91, 45.5%). Patients undergoing an operation from non-general surgical services had higher readmission, unfavorable discharge and mortality rates, a greater incidence of stoma formation, and required a tracheostomy or were TPN-dependent (all p < 0.001). The mortality rate is higher in elderly patients needing an EL when initially admitted through a non-general surgery service. A correct and rapid initial diagnosis and decision are crucial when treating elderly individuals; initial admission to a general surgery service increases the probability of discharge home.