Postoperative Outcome and Predictors among Patients Undergoing Emergency Laparotomy at Selected Southern Ethiopian, Governmental hospitals, 2022: Multicenter Prospective cohort study

Abstract Background: Globally emergency laparotomy is frequently performed surgery. It is a resource intensive surgical procedure with a high morbidity and mortality rates even in the best healthcare systems. Poor post-operative outcome predispose patients to prolonged recovery, increased length of stay and worsened clinical status. Limited data is available in our country regarding postoperative outcomes of emergency laparotomy therefore, this study aimed to assess outcome of emergency laparotomy. Objective: To assess post operative outcomes and predictors among patients undergoing emergency laparotomy at selected Southern, Ethiopian governmental hospitals. Methods: Multi center prospective cohort study was conducted. And data were collected at selected hospitals after obtaining ethical approval from the institutional review board. Continuous data were presented as mean, median, and standard deviation (SD) and the categorical data were presented as the percentage in each category. Data were analysed using SPSS version 26. Multivariable logistic regression analysis was conducted. The significant level of prediction was considered with P value < 0.05 and an adjusted odds ratio was calculated (AOR) at 95% confidence interval (CI). Result: The rate of post operative complication after emergency laparotomy surgery was 39.3% with a mortality rate of 8.4% and length of hospital stay 9 ± (6.5 SD) days. The predictors of post operative complication was Co morbidity (AOR=10.53, 95% CI=3.85-28.8). ASA category II, (AOR=5.09, 95% CI=1.767 - 14.67), and > ASA III (AOR=4.46, 95% CI=1.18 - 16.89), preoperative sepsis (AOR=7.1, 95% CI=2.29 - 22.03), and duration of symptoms the disease >72 hours (AOR=2.37, 95% CI=1.05-5.39). Conclusion: Our study revealed significant level of post operative complications and mortality; therefore the identified predictors should be sorted and can be applied to the preoperative optimization, risk assessment, and standardization of effective post operative care following emergency laparotomy patients individually.