Post-Operative Complications Following Emergency Laparotomy are Common and Associated with increased Late Mortality - A Retrospective Multi-Centre study

Background and Aims: Emergency laparotomy is associated with a great risk of mortality in the elderly. The hyperadrenergic state induced by surgical trauma may play an important role in the pathophysiology of this increased risk. Studies have shown that beta-blocker exposure may be associated with decreased morbidity and mortality in the perioperative period. We aimed to study the effect of beta-blocker on mortality in geriatric patients undergoing emergency laparotomy. Material and Methods: This is a retrospective study of patients who underwent emergency laparotomy between 1 January 2015 and 31 December 2016 at a single institution. The outcomes of interest were the association between post-operative complications and in-hospital and 1-year mortality in patients on beta-blocker therapy (BB(+)) and those who were not (BB(−)). The Poisson regression analysis was used to evaluate the association. Results: A total of 192 patients were included of whom 62 (32.2%) had pre-operative beta-blocker therapy with continued exposure during their hospital stay. The in-hospital mortality was 17.7% in the BB(+) and 23.8% in the BB(−) cohorts ( p = 0.441). One-year mortality was significantly lower in the BB(+) group compared to the BB(−) group (30.6% versus 47.7%; p = 0.038). After adjusting for confounders, the incidence of deaths during 1 year post-operatively decreased by 35% in the BB(+) group (incidence rate ratio = 0.65, p = 0.004). No significant differences in the incidence of post-operative complications between the two groups could be measured. Conclusion: Beta-blocker therapy may be associated with reduced 1-year mortality following emergency laparotomy in geriatric patients.

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The impact of compensation on late mortality after traumatic brain injury: A multi-centre study

Brain Injury ◽

10.1080/02699052.2017.1298002 ◽

2017 ◽

Vol 31 (8) ◽

pp. 1044-1049 ◽

Cited By ~ 2

Author(s):

Thomas Munro Gates ◽

Ian James Baguley ◽

Grahame Kenneth Simpson ◽

Hannah Louise Holman Barden ◽

Melissa Therese Nott

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Multi Centre Study ◽

Late Mortality ◽

Centre Study ◽

The Impact

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A study of post-operative complications of all emergency laparotomy in a tertiary care hospital within 90 days

Archives of Clinical Gastroenterology ◽

10.17352/2455-2283.000062 ◽

2019 ◽

Vol 5 (2) ◽

pp. 015-018

Author(s):

AR Bansal ◽

MR Mallick ◽

S Jena

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Emergency Laparotomy ◽

Care Hospital ◽

Operative Complications ◽

Post Operative Complications

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Pelvic Canal Narrowing Caused by Triple Pelvic Osteotomy in the Dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633130 ◽

1994 ◽

Vol 07 (03) ◽

pp. 110-113 ◽

Cited By ~ 6

Author(s):

D. L. Holmberg ◽

M. B. Hurtig ◽

H. R. Sukhiani

Keyword(s):

Postoperative Complications ◽

Pelvic Osteotomy ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Canal Width ◽

Operative Complications ◽

Post Operative Complications

SummaryDuring a triple pelvic osteotomy, rotation of the free acetabular segment causes the pubic remnant on the acetabulum to rotate into the pelvic canal. The resulting narrowing may cause complications by impingement on the organs within the pelvic canal. Triple pelvic osteotomies were performed on ten cadaver pelves with pubic remnants equal to 0, 25, and 50% of the hemi-pubic length and angles of acetabular rotation of 20, 30, and 40 degrees. All combinations of pubic remnant lengths and angles of acetabular rotation caused a significant reduction in pelvic canal-width and cross-sectional area, when compared to the inact pelvis. Zero, 25, and 50% pubic remnants result in 15, 35, and 50% reductions in pelvic canal width respectively. Overrotation of the acetabulum should be avoided and the pubic remnant on the acetabular segment should be minimized to reduce postoperative complications due to pelvic canal narrowing.When performing triple pelvic osteotomies, the length of the pubic remnant on the acetabular segment and the angle of acetabular rotation both significantly narrow the pelvic canal. To reduce post-operative complications, due to narrowing of the pelvic canal, overrotation of the acetabulum should be avoided and the length of the pubic remnant should be minimized.

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