Seven Emergency Surgeries Tied to Most Deaths and Complications
Written by Editor   
Thursday, June 02, 2016 12:00 AM

Seven types of emergency general surgeries (EGSs) account for the vast majority of all EGSs (80.0%), deaths (80.3%), complications (78.9%), and inpatient costs (80.2%), according to a retrospective review of 421,476 procedures performed in the United States.

The surgical procedures include partial colectomy, small bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy.  Those who undergo an EGS operation are up to 8 times more likely to die postoperatively than are patients undergoing the same procedures electively. In addition, approximately half of all patients undergoing EGS will develop a postoperative complication, and up to 15% will be readmitted to the hospital within 30 days of their surgery," the researchers write.

The complication rates were 42.80% for partial colectomy, 46.94% for small bowel resection, 8.06% for cholecystectomy, 42.00% for operative management of peptic ulcer disease, 28.09% for lysis of peritoneal adhesions, 7.27% for appendectomy, and 40.15% for laparotomy.

The mortality rates were 5.33% for partial colectomy, 6.47% for small bowel resection, 0.22% for cholecystectomy, 6.83% for operative management of peptic ulcer disease, 1.59% for lysis of peritoneal adhesions, 0.08% for appendectomy, and 23.76% for laparotomy.

The inpatient costs were $27,558.77 for partial colectomy, $28 450.72 for small bowel resection, $10,579.35 for cholecystectomy, $27,095.60 for operative management of peptic ulcer disease, $17,387.27 for lysis of peritoneal adhesions, $9664.30 for appendectomy, and $21,962.55 for laparotomy.

"Although cost was not used to rank the procedures, it is notable that the same 7 procedures ranked by clinical burden also accounted for 80% of all EGS-related inpatient costs," the authors write. 


Source:  http://www.medscape.com/viewarticle/862556