Multidisciplinary perioperative protocol in patients undergoing acute high-risk abdominal surgery

1,200 patients (600 intervention, 600 historical controls) undergoing acute high-risk abdominal (AHA) surgery, defined as major abdominal pathology requiring emergency laparotomy or laparoscopy including reoperations after elective gastrointestinal surgery.

Standardized multidisciplinary perioperative protocol involving continuous staff education, consultant-led attention and care, early resuscitation and high-dose antibiotics, surgery within 6 h, perioperative stroke volume-guided haemodynamic optimization, intermediate level of care for the first 24 h after surgery, standardized analgesic treatment, early postoperative ambulation and early enteral nutrition.

Predefined, consecutive historical cohort of patients from the same department receiving standard care prior to protocol initiation.

30-day mortalityhard clinical