Outcomes of a delirium prevention program after major abdominal emergency surgery: An interventional study.

Background: Postoperative delirium is a common complication after emergency surgery. Delirium is associated with increased morbidity and mortality. Clinical approach varies and pharmacological treatment is ineffective.

Small bowel anastomosis in emergency surgery.

Background: Emergency laparotomy is associated with a high morbidity and mortality rate. The decision on whether to perform an anastomosis or an enterostomy in emergency small bowel resection is guided by surgeon preference alone, and not evidence based. We examined the risks involved in small bowel resection and anastomosis in emergency surgery.

Determining a multidisciplinary intraoperative strategy in emergency surgery for bowel obstruction and its impact on outcomes.

Purpose: Bowel obstruction accounts for around 50% of all emergency laparotomies. A multidisciplinary (MDT) standardized intraoperative model was applied (definitive, palliative, or damage control surgery) to identify patients suitable for a one-step, definitive surgical procedure favoring anastomosis over stoma, when undergoing surgery for bowel obstruction. The objective was to present mortality according to the strategy applied and to compare the rate of laparoscopic interventions and stoma creations to a historic cohort in surgery for bowel obstruction.

Small bowel anastomosis in peritonitis compared to enterostomy formation: a systematic review.

Purpose: Anastomotic leakage after small bowel resection in emergency laparotomy is a severe complication. A consensus on the risk factors for anastomotic leakage has not been established, and it is still unclear if peritonitis is a risk factor. This systematic review aimed to evaluate if an entero-entero/entero-colonic anastomosis is safe in patients with peritonitis undergoing abdominal acute care surgery.

Intraoperative Surgical Strategy in Abdominal Emergency Surgery.

Background: Emergency abdominal surgery is associated with a high rate of postoperative complications and death. Pre- and immediate postoperative bundle-care strategies have improved outcome, but so far, no standardized intraoperative strategies have been proposed. We introduced a quality improvement model of specific intra- and postoperative strategies for the heterogenous group of patients undergoing emergency abdominal surgery.

"Sarcopenia is associated with increased risk of burst abdomen after emergency midline laparotomy: a matched case-control study".

Purpose: Burst abdomen is a serious complication commonly observed after emergency midline laparotomy. Sarcopenia has been associated with increased morbidity and mortality after abdominal surgery. This single-center, retrospective, matched case-control study aimed to investigate the association between sarcopenia and burst abdomen in patients undergoing emergency midline laparotomy.

Associations between malignancy and cardiovascular complications following emergency laparotomy - A retrospective cohort study.

Background: Systemic inflammation in patients with malignant disease has been associated with increased risk of cardiovascular events. The pro-inflammatory perturbations following surgical trauma may further promote adverse perioperative cardiovascular events and increase the risk of patients with cancer undergoing major surgery. Our objective was to estimate the association between malignant disease and postoperative cardiovascular complications.

[Closure of an emergency midline laparotomy].

Closure of an emergency abdominal midline laparotomy is related to potentially serious complications. Main concerns are surgical site infection, wound dehiscence and incisional hernia. In this review, new studies and guidelines are summed up to a set of recommendations applicable to the Danish surgical departments.

Anastomotic technique is not associated with leakage rate after right hemicolectomy.

Introduction: The present study aimed to evaluate the anastomotic leakage rate in relation to anastomotic technique in right hemicolectomy in a single high-volume centre.

Methods: This was a retrospective single-centre study of prospectively collected data of patients undergoing right hemicolectomy or ileocecal resection in an acute or elective setting over a seven-year period in a large University Hospital. Anastomotic leakage, anastomotic technique (hand-sewn versus stapled anastomosis) and potential confounders were registered.

Resumption of oncological therapy in patients with advanced cancer undergoing explorative laparotomy for bowel obstruction.

Introduction: Obstruction of the gastrointestinal tract is a frequent surgical emergency experienced by patients with advanced cancers. We aimed to evaluate factors associated with resumption of post-operative chemotherapy in patients with advanced cancer undergoing explorative laparotomy for bowel obstruction.

Methods: This retrospective cohort study was conducted between 2009 and 2013 at Herlev Hospital, Denmark.

Functional performance and 30-day postoperative mortality after emergency laparotomy-a retrospective, multicenter, observational cohort study of 1084 patients.

Background: Despite the importance of predicting adverse postoperative outcomes, functional performance status as a proxy for frailty has not been systematically evaluated in emergency abdominal surgery. Our aim was to evaluate if the Eastern Cooperative Oncology Group (ECOG) performance score was independently associated with mortality following high-risk emergency abdominal surgery, in a multicentre, retrospective, observational study of a consecutive cohort.

Methods: All patients aged 18 or above undergoing high-risk emergency laparotomy or laparoscopy from four emergency surgical centres in the Capitol Region of Denmark, from January 1 to December 31, 2012, were included.

Standardized Surgical Primary Repair for Burst Abdomen Reduces the Risk of Fascial Redehiscence.

Objective: To determine whether a standardized surgical primary repair for burst abdomen could lower the rate of fascial redehiscence.

Summary Background Data: Burst abdomen after midline laparotomy is associated with increased morbidity and mortality. The surgical treatment is poorly investigated but known for a poor outcome with high rates of re-evisceration (redehiscence).

Readmission and reoperation rates following negative diagnostic laparoscopy for clinically suspected appendicitis: The "normal" appendix should not be removed - A retrospective cohort study.

Background: In cases with clinically suspected appendicitis, there is controversy regarding the decision to remove a macroscopically normal appearing appendix during laparoscopy when no other intra-abdominal pathology is found. The aim of this study was to examine the rate of appendicitis, along with readmission and reoperation rates following diagnostic laparoscopy of clinically suspected appendicitis in patients where the appendix was not removed.

Methods: We performed a retrospective cohort analysis of patients who underwent a diagnostic laparoscopy due to clinical suspicion of appendicitis where no other pathology was found and the appendix was not removed.

[Transarterial embolisation for gastrointestinal bleeding caused by an ulcer].

Upper gastrointestinal bleeding caused by an ulcer is a common condition with approximately 1,500 admissions a year. The mortality is roughly 9%, with an increased risk in elderly with multiple comorbidities. First-line treatment is endoscopic double therapy.

Chronic Pain, Quality of Life and Functional Impairment After Emergency Laparotomy.

Background: Emergency laparotomy is a high-risk procedure with increased morbidity and mortality rates. The long-term outcomes are poorly investigated.The aim was to describe the frequency of chronic postsurgical pain (CPSP), pain-related functional impairment, to evaluate the gastrointestinal quality of life (QoL) and identify risk factors for CPSP after emergency laparotomy.

[Mortality rate after acute laparotomy can be reduced].

Acute abdomen is a common cause of admission to hospital. Emergency laparotomy is associated with a significant morbidity and mortality due to deranged physiology and surgery-induced stress. Damage control laparotomy is on the rise as an operative strategy for the septic abdomen as well as for trauma laparotomy but lacks definition in the non-trauma setting.

A Description of Deaths Following Emergency Abdominal Surgery.

Objective: Emergency major abdominal surgery carries a high mortality rate. The aim of this present study was to characterize a population of deceased abdominal surgical patients, to examine how many died unexpectedly and how many were subject to treatment limitations.

Materials And Methods: We included adult emergency abdominal surgical patients who died within 30 days postoperatively.

Adaptive process triage system cannot identify patients with gastrointestinal perforation.

Introduction: Adaptive process triage (ADAPT) is a triage tool developed to assess the severity and address the priority of emergency patients. In 2009-2011, ADAPT was the most frequently used triage system in Denmark. Until now, no Danish triage system has been evaluated based on a selective group of patients in need of acute abdominal surgery.

Reduced Rate of Dehiscence After Implementation of a Standardized Fascial Closure Technique in Patients Undergoing Emergency Laparotomy.

Objective: In elective surgery, it is well documented that a midline laparotomy should be closed with a slowly absorbable monofilament suture material in a continuous technique, in a ratio of at least 4 : 1. The evidence concerning the suture material or suturing technique in the emergency setting is lacking. We aimed to investigate whether this technique would reduce the rate of dehiscence.

Morbidity and mortality rates after emergency abdominal surgery: an analysis of 4346 patients scheduled for emergency laparotomy or laparoscopy.

Purpose: Emergency abdominal surgery results in a high rate of post-operative complications and death. There are limited data describing the emergency surgical population in details. We aimed to give a detailed analyses of complications and mortality in a consecutive group of patients undergoing acute abdominal surgery over a 4-year period.

Chronic Pain, Quality of Life, and Functional Impairment After Surgery Due to Small Bowel Obstruction.

Background: Emergency laparotomy is a high-risk procedure regarding short-term outcomes; however, long-term outcomes are not well described. The aim of this study was to determine the frequency of chronic postoperative pain, pain-related functional impairment, and incisional hernias and to evaluate the gastrointestinal quality of life after emergency laparotomy due to small bowel obstruction.

Methods: This study was a questionnaire study, conducted at a major gastrointestinal-surgery department in a single tertiary university hospital in Denmark.

Risk factors affecting morbidity and mortality following emergency laparotomy for small bowel obstruction: A retrospective cohort study.

Introductions: To identify risk factors for increased 30-day morbidity and mortality, using standardized measuring tools for the characterization of complications after emergency surgery for small bowel obstruction.

Methods: A retrospective cohort study including patients treated with emergency laparotomy for small bowel obstruction at a Copenhagen University Hospital (2009-2013). Complications were evaluated according to the Clavien-Dindo classification.