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November 24, 2017Perioperative MedicineOpen Access

A systematic review and overview of health economic evaluations of emergency laparotomy

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Key result

Emergency laparotomy is an expensive procedure with most contemporaneous studies indicating in-hospital costs in excess of US$10,000 per patient episode, which rise substantially when societal costs are considered.

Population

Adults undergoing emergency laparotomy across 16 included studies.

Comparison

Emergency laparotomy vs Elective surgery or no comparator

Design

Systematic_review

Authors

SBSohail BampoeUniversity College London Hospitals NHS Foundation TrustPOPeter M. OdorRoyal London HospitalRMRamani MoonesingheNational Health Service

Discussion

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Implication

High costs demand resource planning and cost-effectiveness focus in perioperative care; confirms economic burden and extends calls for targeted efficiency trials.

Study Design

Type

Systematic Review

Structured PICO

P
Population
A systematic review of 16 studies evaluating the primary resource utilisation, healthcare economic, and societal costs of emergency laparotomy in adults across multiple countries.
E
Exposure
Emergency laparotomy
C
Comparator
Elective surgery (in some studies) or no comparator
O
Outcome
Primary resource utilisation, healthcare economic and societal costs

Emergency laparotomy is a high-risk, costly procedure with in-hospital costs exceeding US$10,000 per episode, representing a significant financial burden to healthcare systems worldwide.

Limitations

  • Substantial heterogeneity in the methodologies and quality of published economic evaluations
  • Most studies were partial economic evaluations rather than full economic evaluations
  • Different methods used for cost calculation across studies
  • Potential underestimation of true costs as only two studies reported societal costs
  • Many studies were single-center retrospective analyses
  • Most included studies were partial economic evaluations (direct cost analyses) rather than full economic evaluations
  • Heterogeneity precluded meta-analysis of existing research findings

Cite This Study

Bampoe et al. (2017) conducted a systematic review in Emergency laparotomy. Emergency laparotomy vs. Elective surgery (in some included studies) was evaluated on Primary resource utilisation, healthcare economic and societal costs. Emergency laparotomy is an expensive procedure with most contemporaneous studies indicating in-hospital costs in excess of US$10,000 per patient episode, which rise substantially when societal costs are considered.

synapsesocial.com/papers/6a1ff81ed4e6d3589704bcdfhttps://doi.org/10.1186/s13741-017-0078-z
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Also Consider

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

  1. 1Emergency surgery in the elderly patient: a quality improvement approach2011 · 43 citations
  2. 2Postoperative morbidity survey, mortality and length of stay following emergency laparotomy2015 · 84 citations
  3. 3Incidence and estimated annual cost of emergency laparotomy in England: is there a major funding shortfall?*2012 · 71 citations
  4. 4Use of a pathway quality improvement care bundle to reduce mortality after emergency laparotomy2014 · 227 citations
  5. 5Surgical Workload and Cost of Postoperative Adhesion‐related Intestinal Obstruction: Importance of Previous Surgery2004 · 43 citations