This report examines the care of more than 21,000 patients undergoing emergency bowel surgery across England, Wales, the Isle of Man and, for the first time, Northern Ireland. It shows continued improvements in outcomes, with 30-day mortality falling to 8.1%, while highlighting ongoing variation in care between hospitals.
The reduction in mortality potentially represents over 900 additional survivors per year after an emergency laparotomy, compared to Year 1
The report also identifies persistent delays in recognising and treating patients who require emergency laparotomy. Patients not initially admitted under the care of a general surgical team experienced longer delays to diagnosis and treatment and had more than double the mortality rate of those admitted directly under general surgery.
Key areas for improvement include timely access to diagnostic imaging, administration of antibiotics for patients with infection and sepsis, access to emergency surgery, perioperative risk assessment, and specialist care for older patients living with frailty. The report also highlights continuing challenges with audit case ascertainment and calls for greater oversight of participation and data quality to support improvement in patient outcomes.
