ArticleBMJ open2019
Volume and in-hospital mortality after emergency abdominal surgery: a national population-based study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Salvage surgery for free flap failure in the maxillofacial region: a comprehensive review of principles and outcomes.Annals of medicine and surgery (2012) · 2026Article
- Outcomes of urgent gastrointestinal-related procedures in Latin America (LATAM-URG): a prospective multicentre study.Lancet regional health. Americas · 2026Article
- European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Review
- One-year mortality rates after standardized management for emergency laparotomy: results from the Swedish SMASH study.BJS open · 2024Article
- Triage and outcomes for a whole cohort of patients presenting for major emergency abdominal surgery including the No-LAP population: a prospective single-center observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Observational
- Impact of the COVID-19 pandemic on provision and outcomes of emergency abdominal surgery in Irish public hospitals.Irish journal of medical science · 2022Article
- Increasing the use of perioperative risk scoring in emergency laparotomy: nationwide quality improvement programme.BJS open · 2022Article
- Emergency urolithiasis management at a national level: exploring the need for a care pathway.Irish journal of medical science · 2022Article
- Gastro-intestinal emergency surgery: Evaluation of morbidity and mortality. Protocol of a prospective, multicenter study in Italy for evaluating the burden of abdominal emergency surgery in different age groups. (The GESEMM study).Frontiers in surgery · 2022Article
- Article
- Discharge outcomes among elderly patients undergoing emergency abdominal surgery: registry study of discharge data from Irish public hospitals.BMC geriatrics · 2020Article
- The drivers and impact of emergency care reconfiguration in Ireland: Results from a large mixed-methods research programme.Future healthcare journal · 2020Article
- The problems of smaller, rural and remote hospitals: Separating facts from fiction.Future healthcare journal · 2020Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesEmergency abdominal surgery (EAS) refers to high-risk intra-abdominal surgical procedures undertaken for acute gastrointestinal pathology. The relationship between hospital or surgeon volume and mortality of patients undergoing EAS is poorly understood. This study examined this relationship at the national level.
designThis is a national population-based study using a full administrative inpatient dataset (National Quality Assurance Improvement System) from publicly funded hospitals in Ireland.
setting24 public hospitals providing EAS services. PARTICIPANTS AND
interventionsPatients undergoing EAS as identified by primary procedure codes during the period 2014-2018.
main outcome measuresThe main outcome measure was adjusted in-hospital mortality following EAS in publicly funded Irish hospitals. Mortality rates were adjusted for sex, age, admission source, Charlson Comorbidity Index, procedure complexity, organ system and primary diagnosis. Differences in overall, 7-day and 30-day in-hospital mortality for hospitals with low (<250), medium (250-449) and high (450+) volume and surgical teams with low (<30), medium (30-59) and high (60+) volume during the study period were also estimated.
resultsThe study included 10 344 EAS episodes. 798 in-hospital deaths occurred, giving an overall in-hospital mortality rate of 77 per 1000 episodes. There was no statistically significant difference in adjusted mortality rate between low and high volume hospitals. Low volume surgical teams had a higher adjusted mortality rate (85.4 deaths/1000 episodes) compared with high volume teams (54.7 deaths/1000 episodes), a difference that persisted among low volume surgeons practising in high volume hospitals.
conclusionPatients undergoing EAS managed by high volume surgeons have better survival outcomes. These findings contribute to the ongoing discussion regarding configuration of emergency surgery services and emphasise the need for effective clinical governance regarding observed variation in outcomes within and between institutions.
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