- ISSN: 1999-7086
- E-ISSN: 1999-7094
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oa Emergency laparotomy in the elderly: Mortality and morbidity outcomes in a Yemeni Referral Hospital
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المؤلفون:
Yasser Abdurabo Obadiel1
, Shehab Abdulhameed Aiash2 and Haitham Mohammed Jowah1
- المصدر: Journal of Emergency Medicine, Trauma and Acute Care, Volume 2025, Issue 2, مايو ٢٠٢٥, 21
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- ٠٩ ديسمبر ٢٠٢٤
- ١٠ مارس ٢٠٢٥
- ١٤ مايو ٢٠٢٥
Background: This study evaluated the outcomes and associated factors of emergency laparotomy in elderly patients at a referral hospital in Sana’a, Yemen.
Patients and methods: This prospective observational study was conducted at the Al-Gomhori Teaching Hospital Authority in Sana’a, Yemen, between August 2022 and May 2024. A total of 89 patients aged 60 years who underwent emergency laparotomy were included in the study. Data on demographic characteristics, preoperative comorbidities, intraoperative findings, and postoperative outcomes were collected and analyzed. Statistical analyses included descriptive statistics and Fisher’s exact test to determine associations between the study factors and mortality/morbidity, with a significance level of p < 0.05.
Results: The mean patient age was 65.87 ± 7.28 years, with a male predominance (65.2%). The most common indications for surgery were intestinal obstruction (53.9%) and peritonitis (37.1%). The 30-day post-operative mortality rate was 30.3%. Significant associations were found between mortality and preoperative factors such as ischemic heart disease (p = 0.030), chronic renal failure (p = 0.030), and preoperative respiratory dysfunction (p = 0.014). Intraoperative findings, such as mesenteric ischemia (p = 0.014), and postoperative complications, such as sepsis (p < 0.001), were also significantly associated with mortality. Morbidity was significantly associated with hypertension (p = 0.025), intensive care unit (ICU) admission (p = 0.008), and unstable hemodynamic status (p = 0.015).
Conclusion: Elderly patients undergoing emergency laparotomy in Yemen have high morbidity and mortality rates that are influenced by preoperative comorbidities, organ dysfunction, and specific intraoperative and postoperative complications. The challenges of delayed diagnosis, limited resources, and high sepsis rates highlight the difficulties of caring for elderly patients in low-resource settings. Improved preoperative assessment, perioperative care, and targeted postoperative management are crucial for improved outcomes. These findings highlight the importance of tailored surgical care protocols for the elderly in low-resource settings.
