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Seven Most Risky Emergency General Surgeries Identified

Gastrointestinal, bowel operations top the list because they’re often done without planning or prep

WEDNESDAY, April 27, 2016 (HealthDay News) — Seven types of surgeries, including appendectomy and cholecystectomy, account for four out of five emergency general-surgery deaths in the United States, according to research published online April 27 in JAMA Surgery.

Joaquim Havens, M.D., an instructor in trauma and emergency surgery at Brigham and Women’s Hospital in Boston, and colleagues analyzed a government database of claims data involving 421,476 U.S. patients who underwent emergency general surgery between 2008 and 2011. The researchers focused on emergency general surgery performed within two days of hospital admission due to a serious medical condition. The procedures included partial colectomy, small-bowel resection, cholecystectomy, operative management of peptic ulcer disease, lysis of peritoneal adhesions, appendectomy, and laparotomy. Heart-related procedures and surgery prompted by traumatic events like car crashes were excluded from the analysis.

The researchers found these seven surgeries account for 78.9 percent of complications from emergency general surgery. They also found an overall mortality rate of 1.23 percent and a complication rate of 15.0 percent. The average cost per hospital admission was $13,241.

Some of the top seven operations are simply very risky, particularly when performed on an emergency basis, Martin Paul, M.D., regional director of minimally invasive surgery for Johns Hopkins in Washington, D.C., told HealthDay. “Bowel resection is probably, even as an elective procedure, considered a risky operation,” he added. “To do that under emergency circumstances when you don’t have the benefit of a bowel that’s been cleansed ahead of time, it sets the stage for some serious and expensive complications.”

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