Seventh patient report of the National Emergency Laparotomy Audit

The National Emergency Laparotomy Audit (NELA), an ongoing national clinical audit of patients having emergency bowel surgery, has published its seventh patient report. Based on data from December 2019 to November 2020, the report looks at the care received by and outcomes for NHS patients in England and Wales who underwent an emergency laparotomy (emergency bowel surgery). This report, which is based on 21,846 patients who had emergency bowel surgery (55.4% of whom were over the age of 65), found that the national 30-day mortality rate has fallen to 8.7% (from 11.8% in Year 1). Other key findings include:

• Improvements in care have reduced patients’ average hospital stay from 19.2 days in year 1 to 15.1 days in year 7
• 85% of patients now receive a preoperative assessment of risk (up from 84% last year, and 56% in Year 1), and
• 82.3% of high-risk patients were admitted to critical care.

However, the report includes a number of areas where there is scope for improvement. For example, the time taken to give antibiotics in patients with suspected sepsis “remains poor”, with 78.3% not receiving them within one hour. This report makes a number of recommendations, including a call to follow national guidance for the management of patients with suspected abdominal sepsis and commence antibiotic therapy immediately. Read the full report: You can read the report by clicking on the link below. Stay-up-to-date: For notifications of future reports from HQIP, sign up to our mailing list.