Prevalence and Associated Factors of Unplanned Re-Laparatomy after Non-Trauma Emergency Laparatomy in Resource-Limited Settings, 2023: A Retrospective Chart Review

Abstract

BACKGROUND:Emergency laparatomy may need subsequent re-laparatomy which has high rate of mortality. However, reports on rates and associated factors of un-planned re-laparatomy are few. This study aimed to determine the prevalence and associated factors of re-laparotomy after non-trauma emergency laparatomy at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia, 2023. METHODS: This was a retrospective chart review conducted at Debre Markos Comprehensive Specialized Hospital in Ethiopia among patients who had undergone emergency laparatomy between January 1, 2019 and December 31, 2022. A sample of 384 individuals were selected using simple random sampling technique. Data were extracted from March 01, 2023, to May 1, 2023, cleaned, entered into Epi-Data version 3.1, and analyzed with STATA version 14.1. Predictor variables with P value < 0.05 in multivariable logistic regression were reported. RESULTS: From 384 patients who had emergency laparatomy, 33(8.6%) needed re-laparatomy in the early post-operative period. All re-laparotomies were unplanned and done during the primary Hospital admission period. Patients who were hypotensive preoperatively[AOR: 3.3 (95% CI: (1.88, 9.40))] and with longer operation time (greater than 1 hour) [AOR: 4.5 (95% CI: (1.88, 10.64)] had increased risk for unplanned re-laparatomy. CONCLUSION: The re-laparatomy rate in this study was high with higher risk among patients with preoperative hypotension and longer procedure time. The findings emphasize a need for advocacy on preoperative patient resuscitation and monitoring.