Outcomes in Emergency Laparotomies During COVID-19 Pandemic

Barking, Havering and Redbridge University Hospitals NHS Trust

Status: Completed

Conditions: COVID-19; Emergency General Surgery

Treatments: Procedure: Emergency Laparotomy

Study type: Observational

Funder types: Other

Identifiers

NCT04419571

133196

Details and patient eligibility

About

NLR has previously been observed to correlate with complications in upper GI (1) and colorectal (2) surgery. The investigators sought to assess if a similar correlation can be identified in emergency general surgical patients and if the presence of suspected or confirmed COVID-19 may impact on this.

Given the heterogeneity of emergency general surgery the investigators therefore plan to perform a retrospective review of patients having emergency laparotomies only at a single NHS site during COVID-19 pandemic. Assessment of outcomes and Neutrophil:lymphocyte ratio as a predictor of outcomes will be completed. Outcomes will be completed in line with the recent COVIDSurg study criteria (3). The primary outcome is 30-day mortality. Secondary outcomes are 7-day mortality, re-operation, length of stay, post-operative respiratory failure, post-operative ARDS (Acute Respiratory Distress Syndrome), post-operative sepsis and ITU (Intensive Therapy Unit)/HDU (High Dependency Unit) admission.

Enrollment: 94 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patients undergoing emergency laparotomy (change made due to heterogeneity of emergency general surgery)

Exclusion criteria

• Inherited or acquired immunodeficiency (which may directly skew NLR)

Trial design

94 participants in 2 patient groups

Suspected or Confirmed COVID-19

Description:

All adult patients (\>17 years) undergoing emergency (laparotomy) surgery at a single centre (Queens Hospital, Romford, UK) with clinically or radiologically suspected COVID-19, or with viral PCR confirmation; diagnosis made 7-days before and 30-days after date of surgery in accordance with the COVIDsurg study criteria (3).

Treatment:

Procedure: Emergency Laparotomy

Negative or non-suspected COVID-19

Description:

All adult patients (\>17 years) undergoing emergency (laparotomy) surgery at a single centre (Queens Hospital, Romford, UK) without clinically or radiologically suspected COVID-19, or without viral PCR (Polymerase Chain Reaction) confirmation.

Treatment:

Procedure: Emergency Laparotomy