Mortality and major complications after emergency laparotomy: A pilot study of risk prediction model development by preoperative blood-based immune parameters.

Background: Emergency laparotomy is associated with high risk of postoperative complications and mortality. Preoperative identification of patients at high risk of adverse outcome is important. The immune response to conditions requiring emergency laparotomy is not understood in detail.

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.

Pathology is common in subsequent visits after admission for non-specific abdominal pain.

Introduction: Although not supported by evidence, there may be a risk of overlooking pathological findings at patients' return visit after emergency admission for non-specific abdominal pain (NSAP). The primary aim of this study was to evaluate the risk of missed acute pathology in patients primarily discharged with NSAP and re-admitted within three months.

Methods: This was a retrospective review of hospital records within a three-month period (1 September-30 November, 2014) in a university hospital with unrestricted referral of abdominal emergency patients.

Increased Gastrointestinal Surgical Hospital Burden After Laparoscopic Gastric Bypass for Obesity: A Nationwide 5-years Follow-up Study.

Objective: To study long-term gastrointestinal surgical hospital burden (hospital readmissions and gastrointestinal surgical procedures) after laparoscopic gastric bypass.

Background: Little is known about gastrointestinal surgical hospital burden after laparoscopic gastric bypass.

Methods: Danish patients undergoing laparoscopic gastric bypass (BMI >35-50) from January 1, 2005 to December 31, 2013 were included (100% follow-up).

Sarcopenia predicts 90-day mortality in elderly patients undergoing emergency abdominal surgery.

Purpose: Image-based measurement of sarcopenia is an established predictor of a decreased outcome for a large variety of surgical procedures. Sarcopenia in elderly patients undergoing emergency abdominal surgery has not been well studied. This study aims to investigate the association between the total psoas area (TPA) and postoperative mortality after 90 days in a group of elderly emergency laparotomy patients.

Validation and calibration of self-reported height and weight in the Danish Health Examination Survey.

Background: Body mass index (BMI) derived from self-reported information is widely used and the validity is therefore crucial. We aim at testing the validity of self-reported height and weight, and to test if the accuracy of self-reported information can be improved by calibration by testing if calibration improved the ability to predict diabetes.

Methods: Data from Danish Health Examination Survey (DANHES) was used.

The impact of acute high-risk abdominal surgery on quality of life in elderly patients.

Introduction: Undergoing acute high-risk abdominal (AHA) surgery is associated with reduced survival and a great risk of an adverse outcome, especially in the elderly. The primary aim of this study was to investigate the residential status and quality of life in elderly patients undergoing AHA surgery.

Methods: From 1 November 2014 to 30 April 2015, consecutive patients (≥ 75 years) undergoing AHA surgery were included for follow-up after six months.

Laparoscopy in major abdominal emergency surgery seems to be a safe procedure.

Introduction: Laparoscopy is well established in the majority of elective procedures in abdominal surgery. In contrast, it is primarily used in minor surgery such as appendectomy or cholecystectomy in the emergent setting. This study aimed to analyze the safety and effectiveness of a laparoscopic approach in a large cohort of major abdominal emergencies.

Prediction of Outcome After Emergency High-Risk Intra-abdominal Surgery Using the Surgical Apgar Score.

Background: With current literature quoting mortality rates up to 45%, emergency high-risk abdominal surgery has, compared with elective surgery, a significantly greater risk of death and major complications. The Surgical Apgar Score (SAS) is predictive of outcome in elective surgery, but has never been validated exclusively in an emergency setting.

Methods: A consecutive prospective single-center cohort study of 355 adults undergoing emergency high-risk abdominal surgery between June 2013 and May 2014 is presented.

Gastrointestinal bleedings during therapy with new oral anticoagulants are rarely reported.

Introduction: Post-marketing surveillance of drugs relies on spontaneous reporting of adverse drug events to the Danish Health and Medicines Authority. A number of new oral anticoagulants (NOAC) have recently been marketed in Denmark. The purpose of this study was to evaluate the reporting of serious adverse drug events in patients treated with a NOAC and admitted for gastrointestinal bleeding.

Increased mortality in the elderly after emergency abdominal surgery.

Introduction: The purpose of this study was to evaluate the relation between preoperative delay and mortality in surgical patients undergoing primary emergency laparotomy (PEL) in an unselected, well-described patient cohort in a university hospital setting.

Material And Methods: This study was a retrospective analysis of patient charts and perioperative documentation in an unselected consecutive cohort of 131 patients. Covariates for survival outcomes were evaluated in a multivariate analysis.

[Mortality during admission in a surgical department].

A review of patient charts in 322 in-hospital deaths in one surgical unit from July 1 2010 to June 31 2011. Overall mortality was 2.9%, with terminal cancer patients, patients unsolvable at admission and patients declining treatment comprising 35.

[Growing need for surgery as the number of elderly rises in Denmark].

In Denmark, the elderly population is growing. In the article, data from the Danish Healthcare Registry (2005-2012) was summarized for hospital admissions and outpatient contacts with surgery in patients above 75 years. Also, the number of surgical procedures and surgical-related costs in 2020 were estimated based on demographic data and the rates surgery in 2012.

[Barriers for the use of traditional clinical data].

Data from electronic medical records can be used in describing clinical problems not covered by traditional clinical databases or traditional quality assurance systems. In this article three main barriers for the use of these data are identified: system knowledge, legislation and technical barriers. Legislative deregulation and implementation of strategic initiatives to further the use of the data is suggested.

Asymptomatic body packers should be treated conservatively.

Introduction: Body packing takes advantage of the human storage capacity within the alimentary tract. Body packing is used for the smuggling of drugs such as heroin, cocaine, amphetamine, hashish and ecstasy. Most body packers are asymptomatic.

Ultrasound-guided drainage of subcutaneous abscesses on the trunk is feasible.

Introduction: Subcutaneous trunk abscesses are frequent, and current treatment options generally involve incision. By contrast, the standard care for breast abscesses is ultrasound-guided drainage. The aim of this study was to evaluate the feasibility of ultrasound-guided drainage combined with antibiotics in the treatment of subcutaneous abscesses on the trunk.

Direct and recurrent inguinal hernias are associated with ventral hernia repair: a database study.

Background: A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery.

Impact of occupational mechanical exposures on risk of lateral and medial inguinal hernia requiring surgical repair.

Objectives: We undertook a register-based cohort study to evaluate exposure-response relations between cumulative occupational mechanical exposures, and risk of lateral and medial inguinal hernia repair.

Methods: Among all men born in Denmark between 1938 and 1988, we established a cohort comprising those aged 18-65 years of age, who had at least 1 year of full-time employment between 1993 and 2007. Using information from a Job Exposure Matrix based on expert judgement and year-by-year information on Danish International Standard Classification of Occupations codes for each individual since 1993, we established time-varying cumulative estimates of exposure to daily lifting activities and standing/walking.

Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults.

The nationwide Danish Hernia Database, recording more than 10,000 inguinal and 400 femoral hernia repairs annually, provides a unique opportunity to present valid recommendations in the management of Danish patients with groin hernia. The cumulated data have been discussed at biannual meetings and guidelines have been approved by the Danish Surgical Society. Diagnosis of groin hernia is based on clinical examination.

[Convalescence and sick leave following inguinal hernia repair].

The duration of convalescence after inguinal hernia repair is determined by a number of factors, among which are information and recommendations given by the surgeon and the general practitioner, level and duration of postoperative pain, type of repair, level of physical activity at work and during leisure activities and development of complications. The literature provides no evidence to support an increased risk of recurrence with early resumption of physical activity after inguinal hernia repair. Patients should be encouraged to resume full activities immediately after surgery, only limited by pain.

Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair.

Objectives: We analyze, on a nationwide basis, the risk of re-reoperation with reference to previous inguinal hernia repair technique.

Summary Background Data: Operation for a recurrent inguinal hernia is common and the risk of re-recurrence is high. There are no large-scale data evaluating the surgical strategy and results after recurrent inguinal hernia repairs.

Pain related sexual dysfunction after inguinal herniorrhaphy.

To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study.

Inguinal herniorrhaphy in women.

Inguinal hernias in women are relatively rare, and an outcome in this specific subgroup of hernias has not been documented in the literature. An analysis was performed using data from the prospective recording of 3,696 female inguinal hernia repairs in the national Danish hernia database, in the 5.5 year period from January 1, 1998 to June 30, 2003, where observation time specific reoperation rates were used as a proxy for recurrence.