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Bowel surgery death risk.

Too many hospital patients are dying following emergency bowel surgery, say experts who have carried out a comprehensive audit of care across England and Wales.

One in 10 patients dies within 30 days of undergoing an urgent, unplanned laparotomy and the authors of the audit report say that some of these deaths could be avoided.

Care for these high-risk patients was lacking at some hospitals and best treatment was not always immediately on hand, the National Emergency Laparotomy Audit team adds.

The government-funded audit, commissioned by the Healthcare Quality Improvement Partnership, studied data from more than 20,000 patients from 192 of 195 eligible NHS hospitals.

Key findings of the audit included that there is a wide variation in care between hospitals; expected care standards  were not met for 30-40% of patients in some hospitals and that only half of patients were seen by a consultant surgeon within the recommended 12 hours.

Other concerns were that one-in-six patients did not arrive in the operating theatre within the recommended timeframes; many patients at high risk of sepsis infection did not receive timely antibiotic therapy and post-operative access to critical or intensive care wards was uneven.

More than 30,000 patients in NHS hospitals in England and Wales have emergency bowel surgery each year.

The procedure, carried out under general anaesthetic, involves making an incision to operate inside the abdomen to treat life-threatening conditions such as bowel obstruction, perforation or a bleed.

Lead surgeon involved in the audit, Iain Anderson, said many clinical teams had already reviewed and improved the way they deliver care. He urged other hospitals to follow suit.

Audit chairman, prof Mike Grocott, said even a modest improvement could have a substantial benefit.

 

 

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