ArticleWorld journal of surgery2023
Implementing Bundle Care in Major Abdominal Emergency Surgery: Long-Term Mortality and Comprehensive Complication Index.
Article in World journal of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 11 citations in OpenAlex.
- Key interventions and outcomes in perioperative care pathways in emergency laparotomy: a systematic review.World journal of emergency surgery : WJES · 2025Pooled it
- Enhanced recovery after surgery protocols following emergency intra-abdominal surgery: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Protocolized care pathways in emergency general surgery: a systematic review and meta-analysis.The British journal of surgery · 2024Pooled it
- The Dissemination of Standardised Care Protocol Guidelines for High-Risk Emergency Abdominal Surgery Patients in Denmark.Acta anaesthesiologica Scandinavica · 2026Article
- Acute severe hyperphosphatemia and secondary hypocalcemia after phosphate enema administration in a constipated post-trauma patient recovering from pelvic surgery: a case report.Journal of surgical case reports · 2026Article
- Safety and efficacy of prophylactic onlay resorbable synthetic mesh with a comprehensive wound bundle at laparotomy closure in high-risk emergency abdominal surgery: an observational study.World journal of emergency surgery : WJES · 2025Observational
- High risk of short-term mortality and postoperative complications in patients with generalized peritonitis undergoing major emergency abdominal surgery-a cohort study.Langenbeck's archives of surgery · 2025Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMajor abdominal emergency surgery (MAES) has a high risk of postoperative mortality and a high complication rate. The aim of this study was to evaluate whether the implementation of a perioperative care bundle reduced long-term mortality and the Comprehensive Complication Index (CCI) after MAES.
methodsThis study was a single-centre retrospective cohort study. Data in the intervention group were collected prospectively and compared with a historical cohort from the same centre. It includes adult patients undergoing MAES. We implemented a care bundle under the name Abdominal Surgery Acute Protocol (ASAP). We initiated fast-track initiatives and standardised optimised care in before, during and after surgery. Data were analysed using survival analysis and multiple regression.
resultsWe included 120 patients in the intervention cohort and 258 in the historical cohort. The one-year mortality rate was 21.7% in the intervention cohort compared to 28.3% in the standard care cohort. Adjusted odds ratio of one-year mortality 0.81 (CI95% 0.41-1.56). The 30-day mortality was lowered from 19.0 to 6.7% (p = 0.003). The CCI in the intervention cohort was 8.7 (IQR 0-34) compared to 21 (IQR 0-36) in the control cohort (p = 0.932) The length of stay increased by two days (p = 0.021). Most cases had 71-80% protocol compliance.
conclusionImplementing bundle care in major abdominal emergency surgery lowered the 30-day postoperative mortality. The difference in mortality was preserved over time although not significant after one year. The changes in the Comprehensive Complication Index were not statistically significant.
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