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January 24, 2025European Journal of Trauma and Emergency SurgeryOpen Access

Long-term impact of emergency laparotomy on health-related quality of life

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Key result

Low post-laparotomy quality of life linked to ~5 fewer days alive and out of hospital.

  • P=0.0001
  • n=215

Why the study?

Emergency laparotomy can result in physical and neuropsychiatric postoperative complaints that potentially impact quality of life, but its effect on HRQoL and subsequent readmission risk required assessment.

Does acquired low health-related quality of life after emergency laparotomy increase the risk of long-term readmission in adult patients?

Population

215 patients undergoing emergency laparotomy who completed baseline HRQoL evaluation

Comparison

Patients with acquired low HRQoL vs maintained HRQoL

Design

Prospective cohort study

Follow-up

180 days

Authors

LSLiv í SoyluUniversity of CopenhagenDKDunja KokotovicUniversity of CopenhagenMKMadeline KvistHerlev Hospital

Discussion

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Implication

Acquired low HRQoL may flag patients needing closer post-laparotomy surveillance; hypothesis-generating for targeted recovery interventions.

Study Design

Type

Cohort (n=215)

Multicenter

No

Structured PICO

Does acquired low health-related quality of life after emergency laparotomy increase the risk of long-term readmission in adult patients?

P
Population
215 adult patients (≥ 18 years of age) undergoing primary or secondary emergency laparotomy due to bowel obstruction, bowel perforation, ischemia, anastomotic leakage, postoperative bleeding, or fascial dehiscence at a single center in Denmark.
I
Intervention
Emergency laparotomy (observational exposure)
C
Comparator
Patients maintaining high health-related quality of life (HRQoL) versus those acquiring low HRQoL by postoperative day 30
O
Outcome
Health-related quality of life (HRQoL) measured by the EQ5D index at postoperative days 30, 90, and 180, and unplanned readmission from POD 30 to POD 180patient reported

Main Result

Absolute Event Rate: 167% vs 172%

p-value: p=0.0001

While most patients recover their baseline health-related quality of life within 180 days after emergency laparotomy, those who acquire low HRQoL postoperatively face a higher risk of long-term readmission and fewer days alive and out of hospital.

Limitations

  • Limited sample size for patients with full record information (n = 73), potentially leading to type II error
  • Inability to reach all patients telephonically, which may introduce selection bias
  • Lack of information on HRQoL during the earliest postoperative period (e.g., POD7 or POD14)
  • Use of the generic EQ5D instrument, which does not capture specific long-term gastrointestinal issues
  • Limited sample size for patients with full record information (n=73), potentially leading to type II error
  • Inability to reach all patients telephonically, potentially leading to selection bias
  • Lack of HRQoL information during the earliest postoperative period (e.g., POD7 or POD14)
  • Use of a generic EQ5D instrument rather than a symptom-specific gastrointestinal quality-of-life index

Cite This Study

Soylu et al. (2025) conducted a cohort in Emergency laparotomy (n=215). Acquired low health-related quality of life (HRQoL) vs. High HRQoL was evaluated on Days alive and out of hospital at 180 days (p=0.0001). Patients who acquired low health-related quality of life 30 days after emergency laparotomy experienced significantly fewer days alive and out of hospital at 180 days compared to those maintaining high quality of life (median 167 vs 172 days, p=0.0001).

synapsesocial.com/papers/6a192fa5f3c200df1057ffefhttps://doi.org/10.1007/s00068-024-02745-y
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Emergency laparotomy in octogenarians: A 5-year study of morbidity and mortality2013 · 78 citations
  2. 2A Systematic Review of Patient‐reported Outcomes in Randomized Controlled Trials of Unplanned General Surgery2015 · 24 citations
  3. 3Emergency General Surgery in the Elderly: Too Old or Too Frail?2016 · 247 citations
  4. 4Quality of life after emergency laparotomy: a systematic review2024 · 15 citations
  5. 5Reporting of health-related quality of life in emergency laparotomy trials: a systematic review and narrative synthesis2023 · 3 citations