Patient reported Impact of Emergency Laparotomy on Employment and Health Status in Patients at One Year Post Surgery

Abstract

Abstract Background Whilst there has been significant improvement in mortality outcomes after emergency laparotomy, there is little information on longer term outcomes in the year after discharge. The main aim of the study was to assess the impact that an emergency laparotomy has on patients’ health and employment one-year after surgery. Methods This study was a questionnaire study conducted in a single centre district general hospital of patients who had undergone an emergency laparotomy between October 2015 and December 2016. Patients were included according to the National Emergency Laparotomy Audit criteria. At screening, patients who were alive at 1 year and had capacity to consent were approached between January and December 2017. Patients underwent a researcher-led telephone interview using a semi-structured questionnaire to assess the impact on overall, general and physical health (Glasgow Benefit Inventory) as well as employment status. The symptoms patients experienced, and their impact were also recorded. Results Forty-two patients responded to and completed the questionnaire. Just over one third of patients experienced a deterioration in their general or physical health and twenty-one percent of patients experienced a change in employment. Factors which significantly impacted on health status were stoma issues, postoperative morbidity and a change in employment (p < 0.05). The main symptoms which patients identified as being troublesome were bowel function and stoma issues with a resultant social and psychological impact. Conclusions One third of patients experienced a deterioration in their psychosocial and physical health status as well as a change in employment during the first-year post-surgery. Larger research studies are required to define the impact of emergency laparotomy on patients in the longer term and more research is needed to improve perioperative rehabilitation in the post-operative period to ensure optimal functional gain after technically successful surgery.