Fatores relacionados aos desfechos em indivíduos submetidos a cirurgia de urgência e emergência por causas não traumáticas em um hospital universitário: Um estudo retrospectivo

Abstract

Background: Urgent and emergency surgery is an immediate approach to acute conditions. Currently, despite advances in surgical care, many hospitals face challenges of a varied nature, impacting the quality and effectiveness of emergency procedures. Objective: To analyze the stages in non-traumatic urgent and emergency abdominal surgeries at the Hospital Universitário de Lagarto. Method: Retrospective cross-sectional study in patients undergoing urgent and emergency abdominal surgical procedures at HUL, by laparotomy or laparoscopy performed between 2022 and 2023, excluding traumatic or transferred cases. Results: During this period, 334 emergency abdominal surgeries were performed, with a fatality rate of 2.39%. The age of the patients impacted the clinical outcomes, individuals who were discharged from hospital had a mean age of 40 years, while those who died had a mean age of 62 years (p = 0.003). Acute appendicitis accounted for 51.8% of cases, while unspecified acute abdomen had a higher incidence of deaths (p = 0.006). In addition, the presence of comorbidity and a Charlson comorbidity index greater than 3 demonstrated a greater impact on mortality (p < 0.05). Laboratory data on the second postoperative day showed significant relevance, with lower hemoglobin levels and higher leukocyte counts in individuals in the death group (p < 0.05). Appendectomy was related to more favorable outcomes (p = 0.023). Postoperative complications and use of blood concentrates were more prevalent in the death group (p < 0.05). Conclusion: The association between individual clinical parameters and unfavorable outcomes indicates clinical evaluation and individualized management. Improvement of treatment protocols in order to reduce postoperative complications is relevant. Methodological limitations suggest the need for further studies.