National Emergency Laparotomy Audit (NELA) in a District General Hospital, Northern Ireland
Published: 2019-06-04
Page: 12-17
Issue: 2019 - Volume 2 [Issue 1]
Grace Hui Chin Lim *
Department of General Surgery, Daisy Hill Hospital, 5 Hospital Road, BT35 8DR, Newry, Southern Health and Social Care Trust, United Kingdom.
Kealan McLaughlin
Department of General Surgery, Daisy Hill Hospital, 5 Hospital Road, BT35 8DR, Newry, Southern Health and Social Care Trust, United Kingdom.
Joanne Hui Yee Lim
Aberdeen Royal Infirmary, NHS Grampian, Scotland, United Kingdom.
Bryan Chang Wei Lim
National University of Ireland Galway, Ireland.
Dafalla Elamin
Department of General Surgery, Daisy Hill Hospital, 5 Hospital Road, BT35 8DR, Newry, Southern Health and Social Care Trust, United Kingdom.
Mohi Babiker
Department of General Surgery, Daisy Hill Hospital, 5 Hospital Road, BT35 8DR, Newry, Southern Health and Social Care Trust, United Kingdom.
Gerarde McArdle
Department of General Surgery, Daisy Hill Hospital, 5 Hospital Road, BT35 8DR, Newry, Southern Health and Social Care Trust, United Kingdom.
*Author to whom correspondence should be addressed.
Abstract
Emergency laparotomy Audit is the facility that helps to take care of patients in their adverse conditions with the help of advanced medical facilities and tried to cure them every aspect.
Aim: We measured our patient outcomes regarding 30-day mortality rate and morbidity post emergency laparotomies performed in Daisyhill Hospital, Newry and compared it to NELA (National Emergency Laparotomy Audit). This is to identify the reasons in our DGH (Daisyhill Hospital) for the better or worse outcome performance to improve patient care.
Methods: This audit is carried out over a two years duration from August 2015 to August 2017. Data were collected from the theatre log, surgeons log, secretarial operation notes log and Northern Ireland Electronic Care Record. Inclusion and exclusion criteria of patients were met as set out by NELA.
Results: Total number of patients included in the audit is 112. Out of 112, 53 patients are female, and 59 are male. The median age is 65.5-year-old with a range from 19 to 87 years old. The 30-day mortality rate is 7.1% (n=8) which is 1.5 times lower than the national 30-day mortality rate. 90-day mortality rate is 0.9% (n=1).
Conclusion: Our unit is performing well compared to NELA patient outcomes regarding 30-day mortality rate post emergency laparotomy. We would recommend detailed data collection including the time of day of operation, ASA (American Society of Anesthesiologist) grading and p-possum score.
Keywords: Laparotomies, ASA grading, secretarial operation, mortality rate, p-possum score