Ulus Travma Acil Cerrahi Derg. 2023; 29(4): 505-513 | DOI: 10.14744/tjtes.2022.01264

Variables affecting mortality rates in patients undergoing emergency abdominal surgery: A retrospective cross-sectional study

Necmiye Ay¹, Abdurrahim Derbent², Ayça Sultan Þahin³, Naime Yalcin³, Mine Çelik^1
1Department of Anesthesiology and Reanimation, Baþakþehir Çam and Sakura City Hospital, Ýstanbul-Türkiye
²Department of Anesthesiology and Reanimation, Ege University Faculty of Medicine, Ýzmir-Türkiye
³Department of Anesthesiology and Reanimation, University of Health Sciences, Kanuni Sultan Suleyman Training and Research Hospital, Ýstanbul-Türkiye

BACKGROUND: Patients operated under emergency conditions have a higher risk of death and complications than those per-formed under elective conditions. Especially the patient group with high comorbidity needs to be evaluated more specifically. Accord-ing to the surgical risk and American Society of Anesthesiologists (ASA) scoring, the perioperative risk should be determined quickly, and the relatives of the patients should be informed. This study aimed to evaluate the factors affecting mortality and morbidity in patients undergoing emergency abdominal surgery.
METHODS: A total of 1065 patients aged 18 years and older who underwent emergency abdominal surgery in 1 year were included in the study. The primary aim of this study was to determine the mortality rates in the first 30 days and 1 year and the variables af-fecting these rates.
RESULTS: Of 1065 patients, 385 (36.2%) were female and 680 (63.8%) were male. The most common procedure was appendectomy (70.8%), followed by diagnostic laparotomy (10.2%), peptic ulcus perforation (6.7%), herniography (5.5%), colon resection (3.6%), and small bowel resection (3.2%). There was a significant difference between the age of the patients and mortality (p<0.05). There is no statistically significant relationship between gender and mortality. A statistically significant correlation was found between ASA scores, perioperative complication, perioperative blood product use, reoperation, intensive care unit admission, hospitalization time, periop-erative complication, and 30-day mortality and 1-year mortality. There is a significant relationship between trauma and only 30-day mortality (p=0.030).
CONCLUSION: The morbidity and mortality of patients operated on under emergency conditions increased compared to elective surgical operations, especially those over age 70. The 30-day mortality rate of patients who underwent emergency abdominal surgery is 3%, while the 1-year mortality rate is 5.5%. Mortality rates are higher in patients with a high ASA risk score. However, mortality rates in our study were found to be higher than the mortality rates in ASA risk scoring.

Keywords: Anesthesia, complications, emergency; laparotomy; mortality.

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Acil batýn cerrahisi geçiren hastalarda mortalite oranlarýný etkileyen deðiþkenler: Geriye dönüm kesitsel çalýþma

Necmiye Ay¹, Abdurrahim Derbent², Ayça Sultan Þahin³, Naime Yalcin³, Mine Çelik^1
1Baþakþehir Çam ve Sakura Þehir Hastanesi, Anesteziyoloji ve Reanimasyon Kliniði, Ýstanbul
²Ege Üniversitesi Týp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalý, Ýzmir
³Kanuni Sultan Süleyman Eðitim ve Araþtýrma Hastanesi, Anesteziyoloji ve Reanimasyon Kliniði, Ýstanbul

AMAÇ: Acil þartlarda opere edilen hastalarýn ölüm ve komplikasyon riski elektif þartlarda yapýlan operasyonlara göre daha fazladýr. Özellikle ko-morbitesi fazla olan hasta grubunun özel olarak deðerlendirilmeleri gerekmektedir. Cerrahi risk ve ASA skorlamasýna göre hýzlýca peroperatif risk belirlenip hasta yakýnlarý bilgilendirilmelidir. Bu çalýþmada, acil batýn cerrahisi geçiren hastalarda mortalite ve morbiditeyi etkileyen faktörleri deðer-lendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Bir yýl içinde acil batýn cerrahisi geçiren 18 yaþ ve üzeri toplam 1065 hasta çalýþmaya dahil edildi. Bu çalýþmanýn amacý, ilk 30 gün ve bir yýl içindeki mortalite oranlarýný ve bu oranlarý etkileyen deðiþkenleri tespit edebilmekti.
BULGULAR: 1065 hastanýn 385’i (%36.2) kadýn, 680’i (%63.8) erkek idi. En yaygýn prosedür apendektomi (%70.8) olup, ardýndan tanýsal laparotomi (%10.2), peptik ulcus perforasyonu (%6.7), herniografi (%5.5), kolon rezeksiyonu (%3.6), ince baðýrsak rezeksiyonuydu (%3.2). Hastalarýn yaþý ile mortalite arasýnda anlamlý fark bulundu (p<0.05). ASA skorlarý, peroperatif komplikasyon, peroperatif kan ürünü kullanýmý, reoperasyona alýnma, yoðun bakýma yatýþ, hastane yatýþ süresi ve peroperatif komplikasyon ile 30. gün mortalite ve bir yýllýk mortalite arasýnda istatistiksel açýdan anlamlý iliþki bulundu. Travma ile sadece 30. gün mortalite arasýnda anlamlý bir iliþki vardýr (p=0.030).
TARTIÞMA: Acil þartlarda opere edilen hastalarýn morbidite ve mortaliteleri, özellikle 70 yaþ üzerinde elektif cerrahi operasyonlara göre artýþ göstermiþtir. Acil karýn ameliyatý geçiren hastalarýn 30 günlük mortalite oraný %3 iken bir yýllýk mortalite oraný %5.5’dir. ASA risk skoru yüksek olan hastalarda mortalite oranlarý daha yüksektir. Ancak çalýþmamýzdaki mortalite oranlarý ASA risk skorlamasýndaki mortalite oranlarýna göre daha yüksek olarak bulunmuþtur.

Anahtar Kelimeler: Acil, anestezi, komplikasyonlar, laparotomi; ölüm oraný.

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