The University of Southampton
University of Southampton Institutional Repository

Mortality of emergency general surgical patients and associations with hospital structures and processes

Ozdemir, B.A., Sinha, S., Karthikesalingam, A., Poloniecki, J.D., Pearse, R.M., Grocott, M.P.W., Thompson, M.M. and Holt, P.J.E. (2016) Mortality of emergency general surgical patients and associations with hospital structures and processes British Journal of Anaesthesia, 116, (1), pp. 54-62. (doi:10.1093/bja/aev372). (PMID:26675949).

Record type: Article

Abstract

BACKGROUND: Variations in patient outcomes between providers have been described for emergency admissions, including general surgery. The aim of this study was to investigate whether differences in modifiable hospital structures and processes were associated with variance in mortality, amongst patients admitted for emergency colorectal laparotomy, peptic ulcer surgery, appendicectomy, hernia repair and pancreatitis.

METHODS: Adult emergency admissions in the English NHS were extracted from the Hospital Episode Statistics between April 2005 and March 2010. The association between mortality and structure and process measures including medical and nursing staffing levels, critical care and operating theatre availability, radiology utilization, teaching hospital status and weekend admissions were investigated.

RESULTS: There were 294 602 emergency admissions to 156 NHS Trusts (hospital systems) with a 30-day mortality of 4.2%. Trust-level mortality rates for this cohort ranged from 1.6 to 8.0%. The lowest mortality rates were observed in Trusts with higher levels of medical and nursing staffing, and a greater number of operating theatres and critical care beds relative to provider size. Higher mortality rates were seen in patients admitted to hospital at weekends [OR 1.11 (95% CI 1.06-1.17) P<0.0001], in Trusts with fewer general surgical doctors [1.07 (1.01-1.13) P=0.019] and with lower nursing staff ratios [1.07 (1.01-1.13) P=0.024].

CONCLUSIONS: Significant differences between Trusts were identified in staffing and other infrastructure resources for patients admitted with an emergency general surgical diagnosis. Associations between these factors and mortality rates suggest that potentially modifiable factors exist that relate to patient outcomes, and warrant further investigation.

Full text not available from this repository.

More information

Accepted/In Press date: 8 August 2015
Published date: January 2016
Keywords: healthcare delivery, health resources, health services research, outcome
Organisations: NIHR Southampton Respiratory Biomedical Research Unit

Identifiers

Local EPrints ID: 389813
URI: http://eprints.soton.ac.uk/id/eprint/389813
ISSN: 0007-0912
PURE UUID: fb5fbdae-660e-4ded-b5a3-384f9b5c9d6f

Catalogue record

Date deposited: 15 Mar 2016 16:54
Last modified: 17 Jul 2017 19:32

Export record

Altmetrics

Contributors

Author: B.A. Ozdemir
Author: S. Sinha
Author: A. Karthikesalingam
Author: J.D. Poloniecki
Author: R.M. Pearse
Author: M.P.W. Grocott
Author: M.M. Thompson
Author: P.J.E. Holt

University divisions

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×