Perioperative medicine & outcomes
Standardized perioperative management in acute abdominal surgery: Swedish SMASH controlled study
Authors' conclusion
Standardized management protocols improved outcomes after emergency laparotomy.
Study context
- Population
- Adults undergoing emergency laparotomy, 42 months (2018–2021)
- Participants
- 1,344 adults
- Exposure
- Standardized perioperative management protocol vs historical control
- Interventionn = 681
- Controln = 663reference
- Outcome
- Mortality
- Follow-up
- 30 days
Methodological detailsprospective intervention cohort, retrospective control group
- Prospective intervention cohort
- Retrospective control group
Main finding
As reported in the abstract
30-day mortality
Control
14.5 per cent
Intervention
10.7 per cent
P = 0.045
Observational data: associations, not effects.
Secondary outcomes
Duration of hospital stay
- Mean hospital stay reduced, control vs intervention (days)
- 11.9 versus 10.2
- P
- P = 0.007
Duration of ICU stay
- Mean ICU stay reduced, control vs intervention (days)
- 5.40 versus 3.12
- P
- P = 0.007
Antibiotic use
- Increased with new protocol (per cent)
- 81.4 versus 94.7
Time from decision to operate to start of surgery
- Reduced with new protocol (h)
- 3.80 versus 3.22
Anastomoses performed
- Fewer anastomoses (per cent)
- 22.5 versus 16.8
Safety
Serious surgical complications (grade IIIb-V)
- Lower rate, control vs intervention (per cent)
- 37.6 versus 27.3
- P
- P = <0.001
Original publication
Standardized perioperative management in acute abdominal surgery: Swedish SMASH controlled study. Br J Surg. Published 18 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →