117 Predictors of Postoperative Outcomes in Emergency Laparotomy for Gastrointestinal Perforations in Low-Resource Settings

Abstract Background Emergency laparotomy for gastrointestinal (GI) perforation is a common procedure in the emergency department, with high morbidity and mortality rates. Improving patient outcomes following emergency laparotomy is crucial in developing countries, where the costs of preoperative and postoperative care can be significant. Aim To identify key risk factors associated with increased morbidity and mortality in patients with GI perforations. Method We conducted a retrospective cohort study of patients who underwent emergency laparotomy for surgically confirmed GI perforation at a public tertiary hospital from February 2022 to February 2024. Trauma and known tumor cases were excluded. Demographics, clinical data, laboratory results, and outcomes were collected. The primary outcomes were in-hospital mortality and morbidity, with a focus on long ICU stays. Multivariable regression analysis was used to identify independent factors associated with these outcomes. Results A total of 145 patients were included. The in-hospital mortality rate was 14.48%, and 38.9% required ICU admission. The mean age was 58.7 years (SD ± 12.3), and the mean hospital stay was 9.9 days (SD ± 6.4 days, range: 2–27). Multivariable logistic regression identified age (p < 0.01), Charlson Comorbidity Index (CCI) (p < 0.001), and time to theatre (ORT) (p < 0.001) as independent predictors of morbidity and mortality. Conclusions This study highlights that advanced age, higher CCI, and longer ORT are significant predictors of adverse outcomes in emergency laparotomy for GI perforations. Early diagnosis, prompt surgical intervention, MDT approaches are essential to reduce complications and mortality.