Benjamin H L Tan1, Jemma Mytton, Waleed Al-Khyatt, Christopher T Aquina, Felicity Evison, Fergal J Fleming, Ewen Griffiths, Ravinder S Vohra. 1. *Trent Oesophago-Gastric Unit, City Hospital Campus, Nottingham University Hospitals NHS Trust, Hucknall Road, Nottingham †Department of Health Informatics, University Hospitals Birmingham NHS Foundation Trust, Yardley Court, 11-13 Frederick Road, Edgbaston, Birmingham ‡Surgical Health Outcomes & Research Enterprise (SHORE), University of Rochester Medical Center. 601 Elmwood Ave, Rochester, NY §Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, UK.
Abstract
OBJECTIVE: The aim of this study was to compare mortality following emergency laparotomy between populations from New York State and England. SUMMARY OF BACKGROUND DATA: Mortality following emergency surgery is a key quality improvement metric in both the United States and UK. Comparison of the all-cause 30-day mortality following emergency laparotomy between populations from New York State and England might identify factors that could improve care. METHODS: Patient demographics, in-hospital, and 30-day outcomes data were extracted from Hospital Episode Statistics (HES) in England and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients older than 18 years undergoing laparotomy for emergency open bowel surgery between April 2009 and March 2014. The primary outcome measure was all-cause mortality within 30 days of the index laparotomy. Mixed-effects logistic regression was performed to model independent demographic variables against mortality. A one-to-one propensity score matched dataset was created to compare the odd ratios of mortality between the 2 populations. RESULTS: Overall, 137,869 patient records, 85,286 (61.9%) from England and 52,583 (38.1%) from New York State, were extracted. Crude 30-day mortality for patients was significantly higher in the England compared with New York State [11,604 (13.6%) vs 3633 (6.9%) patients, P < 0.001]. Patients undergoing emergency laparotomy in England had significantly higher risk of mortality compared with those in New York State (odds ratio 2.35, confidence interval 2.24-2.46, P < 0.001). CONCLUSION: The risk of mortality at 30 days is higher following emergency laparotomy in England as compared with New York State despite similar patient groups.
OBJECTIVE: The aim of this study was to compare mortality following emergency laparotomy between populations from New York State and England. SUMMARY OF BACKGROUND DATA: Mortality following emergency surgery is a key quality improvement metric in both the United States and UK. Comparison of the all-cause 30-day mortality following emergency laparotomy between populations from New York State and England might identify factors that could improve care. METHODS:Patient demographics, in-hospital, and 30-day outcomes data were extracted from Hospital Episode Statistics (HES) in England and the New York Statewide Planning and Research Cooperative System (SPARCS) administrative databases for all patients older than 18 years undergoing laparotomy for emergency open bowel surgery between April 2009 and March 2014. The primary outcome measure was all-cause mortality within 30 days of the index laparotomy. Mixed-effects logistic regression was performed to model independent demographic variables against mortality. A one-to-one propensity score matched dataset was created to compare the odd ratios of mortality between the 2 populations. RESULTS: Overall, 137,869 patient records, 85,286 (61.9%) from England and 52,583 (38.1%) from New York State, were extracted. Crude 30-day mortality for patients was significantly higher in the England compared with New York State [11,604 (13.6%) vs 3633 (6.9%) patients, P < 0.001]. Patients undergoing emergency laparotomy in England had significantly higher risk of mortality compared with those in New York State (odds ratio 2.35, confidence interval 2.24-2.46, P < 0.001). CONCLUSION: The risk of mortality at 30 days is higher following emergency laparotomy in England as compared with New York State despite similar patient groups.
Authors: Federico Coccolini; Yoram Kluger; Luca Ansaloni; Ernest E Moore; Raul Coimbra; Gustavo P Fraga; Andrew Kirkpatrick; Andrew Peitzman; Ron Maier; Gianluca Baiocchi; Vanni Agnoletti; Emiliano Gamberini; Ari Leppaniemi; Rao Ivatury; Michael Sugrue; Massimo Sartelli; Salomone Di Saverio; Walt Biffl; Fausto Catena Journal: World J Emerg Surg Date: 2018-03-13 Impact factor: 5.469
Authors: Carla F Justiniano; Adan Z Becerra; Anthony Loria; Zhaomin Xu; Christopher T Aquina; Larissa K Temple; Fergal J Fleming Journal: Surg Endosc Date: 2022-01-13 Impact factor: 3.453
Authors: M Sugrue; R Maier; E E Moore; M Boermeester; F Catena; F Coccolini; A Leppaniemi; A Peitzman; G Velmahos; L Ansaloni; F Abu-Zidan; P Balfe; C Bendinelli; W Biffl; M Bowyer; M DeMoya; J De Waele; S Di Saverio; A Drake; G P Fraga; A Hallal; C Henry; T Hodgetts; L Hsee; S Huddart; A W Kirkpatrick; Y Kluger; L Lawler; M A Malangoni; M Malbrain; P MacMahon; K Mealy; M O'Kane; P Loughlin; M Paduraru; L Pearce; B M Pereira; A Priyantha; M Sartelli; K Soreide; C Steele; S Thomas; J L Vincent; L Woods Journal: World J Emerg Surg Date: 2017-10-23 Impact factor: 5.469
Authors: Deirdre M Nally; Jan Sørensen; Gintare Valentelyte; Laura Hammond; Deborah McNamara; Dara O Kavanagh; Ken Mealy Journal: BMJ Open Date: 2019-11-02 Impact factor: 2.692