One in 10 patients dies within 30 days of undergoing emergency surgery.
The National Emergency Laparotomy Audit team found the care for these high-risk patients was lacking at some hospitals. This is the first audit of its kind focussing on laparotomy. Laparotomy is an open procedure where surgeons access the internal organs via the abdomen.
The audit, commissioned by the Healthcare Quality Improvement Partnership and funded by the government, looked at data from more than 20,000 patients from 192 of 195 eligible NHS hospitals. Over 30,000 patients in England and Wales have this procedure each year.
The operation is performed as an emergency usually to tackle life threatening problems like bowel obstruction, perforation or internal bleeding.
The report found:
- wide variation in care between hospitals
- expected standards of care were not met for 30-40% of patients in some hospitals
- only half of the patients were seen by a consultant surgeon within the recommended 12 hours
- one in six patients did not arrive in the operating theatre within the recommended timeframes, despite the urgent nature of the surgery
- many patients at high risk of sepsis infection did not receive timely antibiotic therapy
- post-operative access to critical or intensive care wards was patchy
Miss Clare Marx, president of the Royal College of Surgeons, is concerned the mortality rate for the procedure remains too high.
“This audit demonstrates patients are still not accessing a consistently high standard of care from initial assessment through to post-operative care,” she said.
Patrick Oliver specialist clinical negligence solicitor at Setfords Solicitors commented: “Practitioners in my area know only to well what can happen to patients when things go wrong following such surgery. I am glad that the audit has courageously brought these shortfalls to light so that patient safety can be improved.”
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