Outcome audit of emergency gastrointestinal surgeries in a tertiary care centre: a prospective observational study

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Background: Emergency gastrointestinal (GI) surgery is associated with substantial postoperative morbidity and mortality. Local outcome audits can identify high-risk presentations and opportunities to improve perioperative care. Aim: To describe the clinical profile and outcomes of patients undergoing emergency GI surgery and assess associations between selected clinical and operative variables and mortality. Methods: A prospective observational study was conducted in the emergency surgery service of a tertiary care hospital over 18 months. One hundred patients aged 18–65 years undergoing emergency GI surgery were included after consent. Demographic, clinical, operative and postoperative variables were recorded, with follow-up for 30 days. Categorical variables were summarized as frequencies and percentages; continuous variables as mean ± standard deviation. Associations were assessed using chi-square and between-group tests, with p < 0.05 considered statistically significant. Results: The mean age was 42.92 ± 14.8 years; 49 patients (49%) were male and 51 (51%) female. Appendicitis was the most common diagnosis (54%), followed by intestinal perforation (29%), intestinal obstruction (13%) and blunt abdominal trauma (4%). Peritoneal contamination was recorded in 49% and multiple procedures in 24%. Postoperative complications occurred in 21%; wound infection was the most frequent (12%), followed by wound dehiscence (5%), renal failure (2%) and respiratory failure (2%). Overall mortality was 10%. Mortality differed significantly by diagnosis, multiple procedures and postoperative complications (each reported p < 0.01). Conclusion: In this single-centre cohort, emergency GI surgery was associated with 21% postoperative morbidity and 10% mortality. Diagnosis at presentation, the need for multiple procedures and postoperative complications were associated with mortality. These findings support careful risk assessment, prompt definitive treatment and structured postoperative surveillance.