TY - JOUR
T1 - Twenty‐year study of in‐hospital and postdischarge mortality following emergency general surgical admission
AU - Ramsay, G
AU - Wohlgemut, J M
AU - Jansen, J O
N1 - We are grateful to Lizzie Nicholson, and the team at the Information Services Division, Scotland for their support in providing us with these data and the Data Safehaven Department of the University of Aberdeen for its storage. The authors would also like to thanks Dr Neil Scott and Dr Rute Vieira of the Department of Medical Statistics, University of Aberdeen for their advice in conducting this research.
PY - 2019/10
Y1 - 2019/10
N2 - Introduction
EGS patients have higher mortality than elective surgical inpatients. Few studies have investigated changes in EGS-associated mortality over time or explored mortality rates post discharge. A comprehensive, population-based analysis of mortality rates in EGS patients, over a 20-year timeframe was therefore conducted.
Methods
This was a cross-sectional study of all adult EGS admissions in Scotland between 1996 and 2015. Data were obtained from national records. Co-morbidities were defined by Charlson co-morbidity index and operations were coded by OPCS4 classifications. Linear and multivariate logistic regression models were used to evaluate changes over time.
Results
Among 1 450 296 patients, the overall inpatient, 30-day, 90-day and one-year mortality rates were 1.8%, 3.8%, 6.4% and 12.5%, respectively. Mortality was influenced by age at admission, co-morbidity, operation performed and date of admission (all p<0.0001) and improved with time on subgroup analysis by age, co-morbidity and operations. Medium-term mortality was high: The one-year mortality rate in patients >75 years was 35.6%. One-year mortality in highly co-morbid patients decreased from 75% to 57% over the timeframe of the study (p<0.0001).
Conclusion
EGS in Scotland has experienced a significant reduction in mortality over time. This analysis of medium-term mortality after EGS admission demonstrates strikingly high rates and, as such, post-discharge management is more than currently appreciated.
AB - Introduction
EGS patients have higher mortality than elective surgical inpatients. Few studies have investigated changes in EGS-associated mortality over time or explored mortality rates post discharge. A comprehensive, population-based analysis of mortality rates in EGS patients, over a 20-year timeframe was therefore conducted.
Methods
This was a cross-sectional study of all adult EGS admissions in Scotland between 1996 and 2015. Data were obtained from national records. Co-morbidities were defined by Charlson co-morbidity index and operations were coded by OPCS4 classifications. Linear and multivariate logistic regression models were used to evaluate changes over time.
Results
Among 1 450 296 patients, the overall inpatient, 30-day, 90-day and one-year mortality rates were 1.8%, 3.8%, 6.4% and 12.5%, respectively. Mortality was influenced by age at admission, co-morbidity, operation performed and date of admission (all p<0.0001) and improved with time on subgroup analysis by age, co-morbidity and operations. Medium-term mortality was high: The one-year mortality rate in patients >75 years was 35.6%. One-year mortality in highly co-morbid patients decreased from 75% to 57% over the timeframe of the study (p<0.0001).
Conclusion
EGS in Scotland has experienced a significant reduction in mortality over time. This analysis of medium-term mortality after EGS admission demonstrates strikingly high rates and, as such, post-discharge management is more than currently appreciated.
UR - http://www.mendeley.com/research/twentyyear-study-inhospital-postdischarge-mortality-following-emergency-general-surgical-admission
UR - https://doi.org/10.1002/bjs5.50187
U2 - 10.1002/bjs5.50187
DO - 10.1002/bjs5.50187
M3 - Article
SN - 2474-9842
VL - 3
SP - 713
EP - 721
JO - BJS Open
JF - BJS Open
IS - 5
ER -