Each hour of surgical delay was not significantly associated with 90-day mortality in high-risk patients undergoing emergency abdominal surgery (adjusted OR 1.003; 95% CI 0.989-1.017).
Cohort (n=2,803)
Yes
Does surgical delay by hour increase 90-day mortality in high-risk patients undergoing emergency abdominal surgery?
In high-risk patients undergoing emergency abdominal surgery, surgical delay by hour was not significantly associated with increased 90-day mortality after adjustment.
Odds Ratio: 1.003 (95% CI 0.989–1.017)
OBJECTIVE: In patients with perforated peptic ulcer, surgical delay has recently been shown to be a critical determinant of survival. The aim of the present population-based cohort study was to evaluate the association between surgical delay by hour and mortality in high-risk patients undergoing emergency abdominal surgery in general. MATERIAL AND METHODS: All in-patients aged ≥ 18 years having emergency abdominal laparotomy or laparoscopy performed within 48 h of admission between 1 January 2009 and 31 December 2010 in 13 Danish hospitals were included. Baseline and clinical data, including surgical delay and 90-day mortality were collected. The crude and adjusted association between surgical delay by hour and 90-day mortality was assessed by binary logistic regression. RESULTS: A total of 2803 patients were included. Median age (interquartile range IQR) was 66 (51-78) years, and 515 patients (18.4%) died within 90 days of surgery. Over the first 24 h after hospital admission, each hour of surgical delay beyond hospital admission was associated with a median (IQR) decrease in 90-day survival of 2.2% (1.9-3.3%). No statistically significant association between surgical delay by hour and 90-day mortality was shown; crude and adjusted odds ratio with 95% confidence interval 1.016 (1.004-1.027) and 1.003 (0.989-1.017), respectively. Sensitivity analyses confirmed the primary finding. CONCLUSIONS: In the present population-based cohort study of high-risk patients undergoing emergency abdominal surgery, no statistically significant adjusted association between mortality and surgical delay was found. Additional research in diagnosis-specific subgroups of high-risk patients undergoing emergency abdominal surgery is warranted.
Vester‐Andersen et al. (Wed,) conducted a cohort in High-risk emergency abdominal surgery (n=2,803). Surgical delay by hour was evaluated on 90-day mortality (adjusted OR 1.003, 95% CI 0.989-1.017). Each hour of surgical delay was not significantly associated with 90-day mortality in high-risk patients undergoing emergency abdominal surgery (adjusted OR 1.003; 95% CI 0.989-1.017).