Emergency gastrointestinal surgery (EGS) is burdened by significant mortality and morbidity rates because it is performed with little to no advance planning or preparation, on patients who are in dire straits. Scott JW et al report that there are more than 3 million patients admitted to US hospitals each year for EGS diagnoses, more than the sum of all new cancer diagnoses. In addition to the complexity of the urgent surgical patient (often suffering from multiple co-morbidities), there is the unpredictability and the severity of the event. Frequently, it is necessary for rapid decision-making that allows a correct diagnosis and an adequate and timely treatment. Moreover, in another study, Havens JM et al report that patients undergoing EGS operations are up to 8 times more likely to die postoperatively than are patients undergoing the same procedures electively. Furthermore, the increase in average life will lead more and more people over 65 to face surgical pathologies in an emergency setting and in the elderly EGS is characterized by a greater morbidity and mortality as well as by a global worsening of the residual quality of life (QoL). The explanation for the high percentage of acute complications could be found in the inevitable reduction of the functional reserve related to the age. An example is the reduction of the body's immune defenses in the humoral response of B cells, in the cell-mediated immune function and macrophage activity which explains the susceptibility to infectious complications, facilitated by the altered integrity of the skin barrier and mucous membranes too. Is in this setting, any tools capable to help the surgeon in the decision making process in order to reduce mortality and morbidity linked to the EGS, could become very useful.
The primary goal is to analyze the clinicopathological findings, management strategies and short-term outcomes of gastrointestinal emergency procedures performed in patients over 18. Secondary goals will be to evaluate and analyze the prognostic role of existing risk-scores to define the most suitable scoring system for gastro-intestinal surgical emergency. Furthermore, we aim to identify any specific parameters that may be used as variables for new scoring systems, peri-operative variables predicting adverse results, and any critical issues in the management of these patients.
We are looking for both retrospective and/or prospective study, and/or interventionist study by any center performing emergency gastro-intestinal surgery. All studies regarding patients over the age of 18, undergoing urgent/emergency abdominal surgery will be of interest for this Research Topic. Emergency procedures are defined as unforeseen, non-elective operations according to the NCEPOD Classification of Interventions. The type of surgical approach taken into account could be both open or minimally invasive, including laparoscopic procedures that are converted to open abdominal procedures.
Variables of interest are:
- 30-day overall postoperative morbidity and mortality rates
- Length of hospital stay
- Admission and length of stay in ICU
- Place of discharge (home or rehabilitation or care facility)
- The number of elderly subjects undergoing yearly emergency surgery
- Frequency of use of frailty score
- The sensitivity and specificity of the common score used in an emergency setting, such us Charlson Age Comorbidity Index (CACI), Simplified Acute Physiology Score II (SAPSII), American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), Calculation of postOperative Risk in Emergency Surgery (CORES), Surgical Mortality Probability Model (SMPM), Urgent Surgery Elderly Mortality (USEM) score, Emergency Surgery Frailty Index (EmSFI), 5 modified Frailty Index (5-mFI)
Emergency gastrointestinal surgery (EGS) is burdened by significant mortality and morbidity rates because it is performed with little to no advance planning or preparation, on patients who are in dire straits. Scott JW et al report that there are more than 3 million patients admitted to US hospitals each year for EGS diagnoses, more than the sum of all new cancer diagnoses. In addition to the complexity of the urgent surgical patient (often suffering from multiple co-morbidities), there is the unpredictability and the severity of the event. Frequently, it is necessary for rapid decision-making that allows a correct diagnosis and an adequate and timely treatment. Moreover, in another study, Havens JM et al report that patients undergoing EGS operations are up to 8 times more likely to die postoperatively than are patients undergoing the same procedures electively. Furthermore, the increase in average life will lead more and more people over 65 to face surgical pathologies in an emergency setting and in the elderly EGS is characterized by a greater morbidity and mortality as well as by a global worsening of the residual quality of life (QoL). The explanation for the high percentage of acute complications could be found in the inevitable reduction of the functional reserve related to the age. An example is the reduction of the body's immune defenses in the humoral response of B cells, in the cell-mediated immune function and macrophage activity which explains the susceptibility to infectious complications, facilitated by the altered integrity of the skin barrier and mucous membranes too. Is in this setting, any tools capable to help the surgeon in the decision making process in order to reduce mortality and morbidity linked to the EGS, could become very useful.
The primary goal is to analyze the clinicopathological findings, management strategies and short-term outcomes of gastrointestinal emergency procedures performed in patients over 18. Secondary goals will be to evaluate and analyze the prognostic role of existing risk-scores to define the most suitable scoring system for gastro-intestinal surgical emergency. Furthermore, we aim to identify any specific parameters that may be used as variables for new scoring systems, peri-operative variables predicting adverse results, and any critical issues in the management of these patients.
We are looking for both retrospective and/or prospective study, and/or interventionist study by any center performing emergency gastro-intestinal surgery. All studies regarding patients over the age of 18, undergoing urgent/emergency abdominal surgery will be of interest for this Research Topic. Emergency procedures are defined as unforeseen, non-elective operations according to the NCEPOD Classification of Interventions. The type of surgical approach taken into account could be both open or minimally invasive, including laparoscopic procedures that are converted to open abdominal procedures.
Variables of interest are:
- 30-day overall postoperative morbidity and mortality rates
- Length of hospital stay
- Admission and length of stay in ICU
- Place of discharge (home or rehabilitation or care facility)
- The number of elderly subjects undergoing yearly emergency surgery
- Frequency of use of frailty score
- The sensitivity and specificity of the common score used in an emergency setting, such us Charlson Age Comorbidity Index (CACI), Simplified Acute Physiology Score II (SAPSII), American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), Calculation of postOperative Risk in Emergency Surgery (CORES), Surgical Mortality Probability Model (SMPM), Urgent Surgery Elderly Mortality (USEM) score, Emergency Surgery Frailty Index (EmSFI), 5 modified Frailty Index (5-mFI)