Determinants of Mortality Outcome after Major Laparotomy in a Tertiary Hospital: An Observational Study
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2017, Vol 4, Issue 2
Abstract
Background: Laparotomy surgery carries significant risk of postoperative mortality due to patient related factors and perioperative events. This observational study was aimed to find out how these factors affect the mortality outcome in patients undergoing laparotomy surgeries. Methods: All patients who underwent major laparotomy and shifted to Intensive Care Unit/ Post Anaesthesia Care Unit (ICU/ PACU) were analyzed. The parameters studied were age,gender, American Society of Anaesthesiologists’ Physical Status (ASA PS), elective or emergency nature of the surgery, anaesthetic technique used and major complications.The study was conducted over a period of 18 months. The data was analyzed using statistical software version 21.0 and significance was tested by setting the p value at 0.05. Observations: Out of 486 patients, the overall mortality was 37(7.6%). Females predominated (62.1%) with a higher mortality rate of 9.6%. There was no statistically significant difference in mortality amongst the different age groups. The mortality rate was observed as steadily increased as per increased ASA PS score. Patients operated as elective procedure were higher (65.6%), but the mortality was higher in those patients operated as emergency procedures (18%). Most of the surgeries (93.4%) were under general anaesthesia, but the choice of anaesthetic technique did not affect the mortality. The patients who required vasopressors therapy and mechanical ventilation were higher in the non survivors. Conclusion: The mortality rate of patients undergoing major laparotomy was comparable with similar studies. Females formed the majority and had an increased mortality. Mortality did not increase with age in this study, but increased with higher ASA PS score and emergency surgical procedures. Majority of the surgeries were done under general anaesthesia, but the choice of anaesthetic technique did not affect the outcome. Patients who were dependant on vasopressors and mechanical ventilation had higher mortality rates.
Authors and Affiliations
K. K. Mubarak
Keywords
Related Articles
- EP ID EP466200
- DOI 10.21088/ijaa.2349.8471.42(pt-II)17.14
- Views 69
- Downloads 0
Effect of Dexmedetomidine Nebulization on Attenuation of Haemodynamic Responses to Laryngoscopy: Randomized Controlled Study
Introduction: Dexmedetomidine is a potent and highly selective alpha (2)-adrenoreceptor agonist. It has sympatholytic and antinociceptive effects which allow hemodynamic stability during stressful condition e.g. Laryngos...
Comparison of Buprenorphine and Tramadol as an Adjuvant to Bupivacaine in Supraclavicular Brachial Plexus Block
Supraclavicular brachial plexus block is a good alternative to general anaesthesia for upper limb surgery below shoulder as it avoids the untoward effects of general anaesthesia. Block when given only with local anaesthe...
Pre-Emptive Analgesic Efficacy of Preincisional I.V. Low Dose Ketamine (0.15mg/kg) in Patients Posted for L.S.C.S. Under Spinal Anaesthesia
Inadequate pain relief after caesarean section delivery impairs mother’s ability to optimally care for her infant and to breastfeed in the immediate postoperative period. Pre-emptive analgesia is an antinociceptive treat...
A Comparative Evaluation of Efficacy of Intrathecal Nalbuphine and Butorphanol as Adjuvant to Hyperbaric Bupivacaine 0.5% for Lower Limb Surgery
Background: Subarachnoid block is the most preferred technique for anaesthetic management for lower limb surgeries. Various adjuvants have been used to improve the efficacy local anaesthetics by hastening the onset and p...
A Comparative Study to Evaluate Efficacy of Two Doses of Intrathecal Clonidine (15mcg Versus 30mcg) as an Adjuvant to Bupivacaine for Prolongation of Spinal Anaesthesia
Clonidine, an a2-agonist, has been used intrathecally as an adjuvant to bupivacaine in spinal anaesthesia, for prolonging anaesthesia and postoperative analgesia. This study was designed to compare efficacy of two doses...