SP 9.10 What Does Critical Care Offer to Patients After Emergency Laparotomy?

Aim

Admission to critical care after emergency laparotomy is a quality measure on the NELA database for high-risk (mortality risk >5%) patients, though relatively little data exists on what organ support these patients require. This audit aimed to quantify the resources required for patients during critical care admission.

Methods

All patients who had emergency surgery with a NELA-predicted mortality risk of >5% at our DGH from 01.04.25 to 30.09.25 were identified from the NELA database. Treatment parameters during critical care admission (length of stay, vasopressor requirements [including mode of delivery], renal replacement therapy and intubation) were recorded.

Results

42 patients were identified; 28 were admitted to critical care. Median length of stay was 2 days (Range 1-26 days). Over two-thirds of patients (68%) required vasopressor support during admission and almost half (46%) required central vasopressors. Median duration of vasopressor support was 1 day (Range 0-19 days).

Only 1 patient required renal replacement therapy. 39% of patients were intubated either at admission, or at some point during their admission to critical care. Median duration of intubation was 0 days (Range 0-20 days), 5 patients (18%) were intubated for >24 hours.

Conclusions

Admission to critical care after emergency laparotomy requires a significant resource allocation for organ support, most commonly blood pressure support with vasopressors, often required centrally. These findings demonstrate that critical care admission after emergency surgery is not for observation alone, but rather for organ support which supports national guidance that recommends routine admission to critical care for high-risk patients.