The need for Paediatric Emergency Laparotomy Audit (PELA) in the UK
| Autor: | Dean Rex, Nicholls E, Okoye B, Rye E, Sunderland R, Sinha Ck |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent medicine.medical_treatment Audit Intensive Care Units Pediatric Patient Readmission Time-to-Treatment Young Adult 03 medical and health sciences 0302 clinical medicine After-Hours Care Laparotomy Abdomen medicine Humans 030212 general & internal medicine Child Retrospective Studies Medical Audit business.industry General surgery Infant General Medicine Length of Stay Process of care United Kingdom Survival Rate Child Preschool 030220 oncology & carcinogenesis Female Surgery Emergencies business Paediatric Surgery Intussusception Needs Assessment Paediatric emergency Intestinal Volvulus |
| Zdroj: | The Annals of The Royal College of Surgeons of England. 102:209-213 |
| ISSN: | 1478-7083 0035-8843 |
| DOI: | 10.1308/rcsann.2019.0141 |
| Popis: | Introduction The National Emergency Laparotomy Audit (NELA) has raised serious concerns about the processes of care and outcomes in adult emergency laparotomies in the UK. To date, no comparable data have been published for children. The aim of this study was to investigate the need for a similar audit in children. Methods Data were collected retrospectively following NELA guidelines. Results were analysed using QuickCalcs (GraphPad Software, La Jolla, CA, US). Results The study period spanned 7.5 years. A total of 161 patients were identified for inclusion in the audit. The median patient age was 2.8 years. Half (49%) of the cohort were deemed ASA (American Society of Anesthesiologists) grade ≥2. A history of previous abdominal surgery was noted in 37% of the patients. The median time from admission to operation was 15 hours. Over a third (39%) of the operations were performed out of hours. The most common indications for surgery comprised adhesive bowel obstruction (37%), intussusception (27%) and volvulus (9%). The median length of hospital stay was 8 days with the median postoperative stay being 6 days (NELA data 10.6 days). Half (51%) of the cases required intensive care following surgery. The 30-day mortality rate was 3.1%. The overall mortality rate was 4.3% (NELA data 16%). Patient care was led by a consultant surgeon in 100% of cases (NELA data 89%). Conclusions This is the first study in children that provides baseline data about the standards of care and outcomes from a single centre paediatric emergency laparotomy audit. A larger study using data from multiple centres would be of great benefit. |
| Databáze: | OpenAIRE |
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