The importance of discussing mortality risk prior to emergency laparotomy
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ORIGINAL ARTICLE
The importance of discussing mortality risk prior to emergency laparotomy Vernon Sivarajah1 · Una Walsh2 · George Malietzis2 · Christos Kontovounisios2,3,4 · Vikas Pandey1 · Gianluca Pellino5,6 Received: 12 February 2020 / Accepted: 23 March 2020 © Italian Society of Surgery (SIC) 2020
Abstract Emergency laparotomies are often required for life-threatening conditions and consequently are associated with high mortality. This risk should be discussed with patients and ideally their next of kin (NOK). Failure to do so denies patients and their relatives the opportunity to prepare, breaches consent guidance, and may result in complaints and negligent claims. Patients who underwent an emergency laparotomy over 6 months were retrospectively studied. Mortality risk discussion with patients and their NOK as evidenced by documentation on consent forms or clinical notes was recorded. Factors influencing these discussions included patient’s age, American Society of Anaesthesiologists’ score, pre-operative diagnosis, Portsmouth Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (P-POSSUM); seniority of consenting surgeon was also investigated. Seventy-six consecutive patients underwent an emergency laparotomy. Sixty-nine had capacity to give consent. Mortality risk was discussed with 24 (34.8%). These patients were older (median age 77.5 v 65.5 years; P
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