Key result
Emergency laparotomy yields a ~4% surgical futility rate within 72 hours of intervention.
Why the study?
Surgical futility after emergency laparotomy is associated with patient distress, moral injury, and opportunity costs, but rates and associated costs needed evaluation.
What is the rate and cost of surgical futility in patients undergoing emergency laparotomy?
Cohort (n=741)
No
What is the rate and cost of surgical futility in patients undergoing emergency laparotomy?
Futile emergency laparotomy occurs in 3.6% of cases and incurs significant healthcare costs, highlighting the need for better preoperative prediction to avoid inappropriate interventions.
Futile laparotomy incurs high costs; leaves open whether preoperative prediction tools can reduce inappropriate interventions.
Background: Surgical futility has been defined as death within 72 h of emergency laparotomy. It is associated with patient distress, moral injury and opportunity costs. This study aimed to determine the rates of surgical futility after emergency laparotomy at a single high-volume centre, and to attribute costs to cases of surgical futility. Methods: A retrospective cohort study was conducted between 1st August 2021 and 1st August 2023 at a single high-volume acute hospital trust in the United Kingdom. A national patient-level costings system was used to determine the costs of hospital care from the day of surgery to the time of death. Results: In a cohort of 741 patients, there was a 3.6 % surgical futility rate. Most of these patients died within 24 h of surgery. The median total cost of admission for each patient was £14,118 (range £6,618 to £29,583). The median cost per day of admission was £6,004 (range £1,324 to £15,255). Conclusion: This is the first study to report the costs of surgical futility in the emergency laparotomy setting. Futile surgery appears to cost more and require more resource than non-futile laparotomies. Further research should focus on how to better predict surgical futility, reduce inappropriate interventions and improve patient care.
No takes yet. Share an insight, caveat, or question.
Downey et al. (2025) conducted a cohort in Emergency laparotomy (n=741). Emergency laparotomy was evaluated on Percentage of futile emergency laparotomies (death within 72 hours of the index surgery). In a cohort of 741 patients undergoing emergency laparotomy, the surgical futility rate was 3.6%, with a median total admission cost of £14,118 per futile case.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: