Table 1.
Demographics and outcomes of patients before and after implementation of the emergency laparotomy pathway quality improvement care bundle
| Site 1 |
Site 2 |
Site 3 |
Site 4 |
All patients |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Before ELPQuiC (n = 51) | After ELPQuiC (n = 109) | Before ELPQuiC (n = 144) | After ELPQuiC (n = 144) | Before ELPQuiC (n = 44) | After ELPQuiC (n = 97) | Before ELPQuiC (n = 60) | After ELPQuiC (n = 77) | Before ELPQuiC (n = 299) | After ELPQuiC (n = 427) | |
| Age (years)* | 66·6(16·6) | 65·3(17·7) | 65·1(16·6) | 63·7(17·5) | 65·7(13·9) | 69·3(14·0) | 66·2(15·0) | 66·0(15·5) | 65·6(15·8) | 65·8(16·5) |
| Sex | ||||||||||
| F | 38 (75) | 56 (51·4) | 73 (50·7) | 79 (54·9) | 19 (43) | 49 (51) | 31 (52) | 41 (53) | 161 (53·8) | 225 (52·7) |
| M | 13 (25) | 53 (48·6) | 71 (49·3) | 65 (45·1) | 25 (57) | 48 (49) | 29 (48) | 36 (47) | 138 (46·2) | 202 (47·3) |
| Outcome at 30 days | ||||||||||
| Alive | 42 (82) | 96 (88·1) | 123 (85·4) | 126 (87·5) | 39 (89) | 89 (92) | 53 (88) | 71 (92) | 257 (86·0) | 382 (89·5) |
| Dead | 9 (18) | 13 (11·9) | 21 (14·6) | 18 (12·5) | 5 (11) | 8 (8) | 7 (12) | 6 (8) | 42 (14·0) | 45 (10·5) |
| Died in hospital | ||||||||||
| No | 41 (80) | 96 (88·1) | 122 (84·7) | 125 (86·8) | 37 (84) | 89 (92) | 52 (87) | 70 (91) | 252 (84·3) | 380 (89·0) |
| Yes | 10 (20) | 13 (11·9) | 22 (15·3) | 19 (13·2) | 7 (16) | 8 (8) | 8 (13) | 7 (9) | 47 (15·7) | 47 (11·0) |
| ASA fitness grade | ||||||||||
| I | 5 (10) | 14 (12·8) | 12 (8·3) | 16 (11·1) | 4 (9) | 8 (8) | 6 (10) | 7 (9) | 27 (9·0) | 45 (10·5) |
| II | 10 (20) | 36 (33·0) | 48 (33·3) | 52 (36·1) | 9 (21) | 32 (33) | 28 (47) | 27 (35) | 95 (31·8) | 147 (34·4) |
| III | 19 (37) | 40 (36·7) | 46 (31·9) | 44 (30·6) | 18 (41) | 40 (41) | 20 (33) | 32 (42) | 103 (34·5) | 156 (36·5) |
| IV | 16 (31) | 18 (16·5) | 31 (21·5) | 26 (18·1) | 12 (27) | 12 (12) | 5 (8) | 10 (13) | 64 (21·4) | 66 (15·5) |
| V | 1 (2) | 1 (0·9) | 7 (4·9) | 6 (4·2) | 1 (2) | 5 (5) | 1 (2) | 1 (1) | 10 (3·3) | 13 (3·0) |
| Length of hospital stay (days)† | 11 (7–24) | 11 (7–21) | 12 (7–23) | 10 (6–18) | 12 (8–21) | 12 (8–19) | 10 (7–21) | 13 (6–32) | 11 (7–23) | 11 (6–21) |
| P-POSSUM risk score* | 0·226(0·282) | 0·251(0·298) | 0·193(0·234) | 0·267(0·307) | 0·200(0·207) | 0·179(0·241) | 0·179(0·237) | 0·159(0·212) | 0·197(0·239) | 0·223(0·278) |
| P‡ | 0·730 | 0·140 | 0·764 | 0·755 | 0·395 | |||||
Values in parentheses are percentages unless indicated otherwise;
*
values are mean(s.d.) and
†
median (i.q.r.) for survivors. ELPQuiC, emergency laparotomy pathway quality improvement care; ASA, American Society of Anesthesiologists; P-POSSUM, Portsmouth modification of Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity.
‡
Test for proportions.