ArticleANZ journal of surgery2024
Impact of routine pre-operative risk assessment on patients undergoing emergency major abdominal surgery in a regional Victorian hospital.
Article in ANZ journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Implementation of risk prediction and stratification approaches for ageing populations in Australian healthcare: a systematic review.The Lancet regional health. Western Pacific · 2026Review
- From prediction to action-Making emergency laparotomy risk scores clinically usable.Surgery in practice and science · 2026Article
- Cost Effectiveness of a Multidisciplinary Perioperative Protocol for High-Risk Emergency Major Abdominal Surgery in a Regional Victorian Hospital.ANZ journal of surgery · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRoutine preoperative risk assessment (RPRA) using objective risk prediction tools may improve the perioperative outcomes of emergency major abdominal surgery (EMAS). This project aims to identify whether the introduction of RPRA with the 'National Emergency Laparotomy Audit (NELA) Calculator' as standard-of-care for EMAS at a regional Victorian hospital has improved postoperative outcomes, reduced unplanned postoperative critical care unit (CCU) admission rates, and impacted the 'no-lap' rate.
methodsAn audit was performed including all adult general surgery patients who required EMAS at Bendigo Health between September 2017 and August 2022, including those palliated up-front. Patients requiring surgery for uncomplicated appendicitis, cholecystitis, trauma, and diagnostic laparoscopy were excluded. Patient demographics, preoperative NELA score, CCU admission data and postoperative outcomes were collected and compared between patients undergoing surgery before and after the introduction of RPRA.
resultsSix hundred and ninety-one patients were included in the analysis. Median NELA score was 5 (IQR 1.5-11.75). 2.60% of patients were palliated up-front and did not proceed to surgery. Among the 673 operative patients, 30-day mortality was 5.20%. Following the introduction of RPRA there was a significant reduction in the unplanned CCU admission rate, from 9.14% to 3.48% (P = 0.04). There was no change in postoperative mortality, severe complication rate or planned CCU admission rate.
conclusionRPRA reduced rate of unplanned CCU admissions. Postoperative mortality and complication rates did not change following introduction of RPRA. RPRA appears useful in guidance of preoperative palliative decision-making, but further study is required to validate its use in this context.
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