Survival Status And Predictors Of In-hospital Mortality Among Adults Undergone Emergency Abdominal Surgery In Ethiopia, 2024

Background and objective: Emergency abdominal surgery is burdened by significant mortality and morbidity rates as it is performed with little to no advance planning or preparation on patients who are in dire straits. This study aims to determine the time to death and predictors of in-hospital mortality among adult patients for whom emergency abdominal surgery has been done. Methods: Retrospective cohort study was conducted among adult patients who undergone surgery for emergency abdominal conditions from January 1, 2019 to December 30, 2023 at Jimma University Medical Center. Three hundred records were selected by proportional sampling technique. Data were collected by structured data extraction checklist using Kobo Toolbox and analysis was done by STATA Version 17. Bivariate Cox regression analysis run to find candidate variables at p-value <0.25 for multivariable Cox regression model. Finally in multivariable Cox-Regression Analysis, the p-value < 0.05 and Adjusted Hazard Ratio (AHR) with 95% CI were used. Results: The median age of patients was 35 (IQR 26-47) years. Out of the 300 patients, 37 had died in the hospital and the overall incidence rate of death was 1.35 (95% CI: 0.98 – 1.86) per 100 person-days. Sixty percent of the patients suffered from at least one type of complication. Being male (AHR=4.1, CI 1.25-15.42), and octogenarians (AHR=7.77, CI 2.57–33.5) had increased hazard of mortality. Patients’ American Society of Anaesthesiologists grade (AHR=2.81, 95% CI: 1.2-6.6), shock (AHR=9.7, 95% CI: 1.8-39.9), and re-laparotomy (AHR=2.18, CI 0.35–13.6) were significant predictors of mortality. Conclusion - The mortality was high in this study. Condition of the patient during presentation and postoperative complications were significant predictors of mortality. Devising special integrated efforts and guidelines for perioperative management of patients can improve survival outcome and decrease postoperative complications.