Effects of establishing a daytime emergency operating theatre in a university hospital

• After establishment of a daytime emergency operating theatre the total number of emergency laparotomies increased, and a higher proportion was performed during daytime hours. • A higher proportion of acute surgeries was requested with high priority, but nevertheless a higher proportion took place within priority. • More elderly patients underwent acute surgery. • The number of cancellations of scheduled surgeries was significantly reduced. • Key outcomes, including hospital length of stay, reoperation rates within seven days, and 30-day mortality remained unchanged. • The study highlights both the benefits and potential challenges of increasing surgical theatre availability. Acute abdominal surgery, constituting a substantial portion of hospital services, is associated with high morbidity and mortality rates. This study aimed to compare two cohorts of emergency laparotomy surgeries: before (Cohort 1) and after (Cohort 2) the establishment of a regular daytime emergency operating theatre at Haukeland University Hospital, Norway. Data were collected from the hospital's operation planning and registration system and then merged with data from the hospital's electronic patient record system. The British National Emergency Laparotomy Audit (NELA) inclusion and exclusion criteria were used. The study found an increase from Cohort 1 to Cohort 2 in the number of surgeries, and in the proportion of urgent surgeries, both requested and started, within 6 h. Results also showed a higher proportion of daytime surgeries in the latter cohort. More elderly patients were operated in Cohort 2, but the low 30-day mortality rate remained unchanged. Other key outcomes, such as length of hospital stay and reoperations within seven days, were also unchanged. The number of cancellations of scheduled surgery was significantly lower after a regular daytime emergency surgery room was available. While improvements were found, the study acknowledges potential challenges and costs associated with the increasing availability of surgical theatres. The findings contribute to ongoing discussions on optimizing acute abdominal surgery pathways.