scholarly journals AB115. Perioperative factors associated with postoperative morbidity after emergency laparotomy: a retrospective analysis in a university teaching hospital

2020 ◽  
Vol 4 ◽  
pp. AB115-AB115
Author(s):  
Alice Moynihan ◽  
Mohamed Ahmed ◽  
Emma Garry ◽  
Waqas Rehman ◽  
James Griffin ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Teaching Hospital ◽  
Postoperative Morbidity ◽  
University Teaching ◽  
Emergency Laparotomy ◽  
Factors Associated

scholarly journals Perioperative factors associated with postoperative morbidity after emergency laparotomy: a retrospective analysis in a university teaching hospital

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
M. Ahmed ◽  
E. Garry ◽  
A. Moynihan ◽  
W. Rehman ◽  
J. Griffin ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Postoperative Morbidity ◽  
Univariate Analysis ◽  
Postoperative Mortality ◽  
University Teaching ◽  
University Hospital ◽  
Emergency Laparotomy ◽  
Comprehensive Complication Index ◽  
Haemodynamic Parameters ◽  
Postoperative Intensive Care

Abstract Emergency Laparotomy (EL) is associated with significant morbidity and mortality. Variation in practice and patient outcomes for patients undergoing emergency laparotomy has been identified through the UK National Emergency Laparotomy Audit (NELA), with 30-day mortality ranging from 11 to 15%. A correlation between preoperative haemodynamic parameters and increased postoperative mortality has been demonstrated by both NELA and other observational studies. The association between intraoperative haemodynamic parameters and overall postoperative morbidity has not been evaluated in EL patients. The aims of our study were to investigate the association between perioperative haemodynamic and logistic parameters and postoperative morbidity in a tertiary referral university hospital; and to compare our outcomes to that of the NELA data. A retrospective analysis correlating a range of perioperative parameters with Comprehensive Complication Index (CCI) among 86 patients who underwent EL during 2018 was conducted. Mean age was 64 years (SD 16). Median CCI was 27 [9–45], and 30-day mortality was 11.7%. Several intraoperative parameters correlated with CCI on univariate analysis. On multivariate analysis, ASA status (P = 0.005) and unplanned escalation to postoperative intensive care (P = 0.03) were independently associated with CCI. Our study shows a correlation between ASA status and unplanned escalation to ITU with increased postoperative morbidity in patients undergoing emergency laparotomy. We did not demonstrate an independent correlation between intraoperative parameters and postoperative morbidity. These findings warrant confirmation in a larger scale observational study. Outcomes in our institution are comparable to those seen in the NELA.

scholarly journals SP5.1.13 Upper gastrointestinal (UGI) mural thickening on Computed Tomography (CT) and its significance in the multi-disciplinary team (MDT) pathway

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Christopher Ashmore ◽  
David Hunter ◽  
Richard Kenningham ◽  
David Bowrey
Keyword(s):  
Computed Tomography ◽  
Retrospective Analysis ◽  
Hiatal Hernia ◽  
Teaching Hospital ◽  
Hiatus Hernia ◽  
Benign Disease ◽  
University Teaching ◽  
High Index Of Suspicion ◽  
Upper Gastrointestinal ◽  
Multi Disciplinary Team

Abstract Aims Patients are frequently referred to the UGI MDT based on CT reported thickening of either the oesophagus, stomach or duodenum. We have sought to illustrate the efficacy of CT within the UGI cancer referral pathway. Method A retrospective analysis was carried out on patients referred to the UGI MDT at a University Teaching Hospital over a 22-month period. Patients referred with CT evidence of UGI tract thickening prior to endoscopy were included. CT findings were correlated with symptomatology, subsequent endoscopy and histology findings. Results 442 patients were referred to the UGI MDT between April 2014 and February 2016. 125 were referred for CT thickening alone (67 (53.2%) oesophageal, 49 (39.2%) gastric, 9 (7.2%) duodenal). 49 (39.2%) patients were subsequently diagnosed with UGI cancer, 57 (45.6%) had evidence of benign disease and 18 (14.4%) patients had no abnormality evident on endoscopy. CT thickening of 15mm and above was significantly more likely be malignant versus thickening less than 15mm [42/87 (48.3%) vs 7/38 (18.4%); p < 0.05]. Patients with thickening in the presence of a hiatus hernia were significantly less likely to have an associated cancer vs those without [3/26 (13%) vs 20/42 (51.1%); p < 0.05]. Conclusion We conclude that patients should not be referred for MDT opinion on CT evidence of UGI thickening alone. All patients should have an endoscopy prior to referral, particularly those with a hiatal hernia on CT. A high index of suspicion for malignancy should be adopted in patients with thickening greater than 15mm on imaging.

scholarly journals Factors Associated With Alcohol Use Disorder Among People Living With HIV/AIDS Attending Art Clinic, Mizan Tep University Teaching Hospital, South West Ethiopia

2019 ◽  
Author(s):  
Bereket Beyene Gebre
Keyword(s):  
Alcohol Use ◽  
Teaching Hospital ◽  
Alcohol Use Disorder ◽  
University Teaching ◽  
Southern Ethiopia ◽  
People Living With Hiv ◽  
Factors Associated ◽  
Khat Chewing ◽  
Living With Hiv ◽  
Hiv Aids

Abstract Abstract Objective: To assess the magnitude of alcohol use and factors among HIV/AIDS positive adults visiting ART clinic at Mizan Tep university Teaching Hospital (MTUTH), Southern Ethiopia from October 2017 to December 2017. Result: A total of 332 participants were enrolled in the study with the prevalence of alcohol use disorder (AUD) of 18.4%. Factors associated with alcohol use disorder were sex AOR=3.48 (95%CI: 1.27, 9.59), cigarette smoking AOR=5.12(95%CI:4.02,8.61), “Khat” chewing AOR=3.23(95%CI: 2.06,6.89),and CD4 count of 0-200 AOR = 19.49 (95% CI:1.74 ,218.4). Key words:-Magnitude, Alcohol use disorder, factors.

Mortality rates of patients undergoing emergency laparotomy in an Irish university teaching hospital

2018 ◽  
Vol 187 (4) ◽  
pp. 1039-1044 ◽  
Author(s):  
Aoife C. Kiernan ◽  
Peadar S. Waters ◽  
Sean Tierney ◽  
Paul Neary ◽  
Maria Donnelly ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Mortality Rates ◽  
University Teaching ◽  
Emergency Laparotomy
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