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Novel Textbook Outcomes Following Emergency Laparotomy: Delphi Exercise Publisher Pubmed

Summary: What’s the ideal surgery outcome? Study defines Textbook Outcomes for emergency laparotomy success. #EmergencySurgery #TextbookOutcomes

Naumann DN1 ; Bhangu A1, 2 ; Brooks A3 ; Martin M4 ; Cotton BA5 ; Khan M6 ; Midwinter MJ7 ; Pearce L8 ; Bowley DM1, 10 ; Holcomb JB9 ; Griffiths EA1 ; Abuabeid A11 ; Peckhamcooper A12 ; Dyas AR13 Show All Authors
Authors
  1. Naumann DN1
  2. Bhangu A1, 2
  3. Brooks A3
  4. Martin M4
  5. Cotton BA5
  6. Khan M6
  7. Midwinter MJ7
  8. Pearce L8
  9. Bowley DM1, 10
  10. Holcomb JB9
  11. Griffiths EA1
  12. Abuabeid A11
  13. Peckhamcooper A12
  14. Dyas AR13
  15. Adeyeye A14
  16. Dogjani A15
  17. Ball ACY16
  18. Wolthuis AM17
  19. Quirogagarza A18
  20. Karamarkovic AR19
  21. Giordano A20
  22. Fuchs A21
  23. Julianov A22
  24. Phillips AW23
  25. Zimmermann A24
  26. Charalabopoulos A25
  27. Birkun AA26
  28. Narvaezrojas AR27
  29. Guner A28
  30. Fayed A29
  31. Davis AL30
  32. Vereczkei A31
  33. Balla A32
  34. Celotti A33
  35. Romanzi A34
  36. Trombetta A35
  37. Beggs AD36
  38. Robertson AG37
  39. Petrosoniak A38
  40. Davies AR39
  41. Becerrabolanos A40
  42. Loria A41
  43. Brillantino A42
  44. Athanasiou A43
  45. Isik A44
  46. Ioannidis A45
  47. Santos AP46
  48. Saha AK47
  49. Vilchesmoraga A48
  50. Choudhry AJ49
  51. Tsuchiya A50
  52. Smithers BM51
  53. Wijnhoven BPL52
  54. Keeler BD53
  55. De Simone B54
  56. Birla R55
  57. Mitra B56
  58. Atanasov BC57
  59. Badgwell B58
  60. Nolan B59
  61. Kang BH60
  62. Duffy CC61
  63. Ordonez CA62
  64. Gomes CA63
  65. Mueller CL64
  66. Reinke CE65
  67. Lebares CC66
  68. Hunter CJ67
  69. Villodre C68
  70. Guldogan CE69
  71. Seretis C70
  72. Pilgrim CHC72
  73. Varghese C73
  74. Owoo C74
  75. Meyhoff CS75
  76. Fleming CA76
  77. Stuart CM77
  78. Lewislloyd CA78
  79. Mclaughlin CJ79
  80. Stevens CL80
  81. Graham CA81
  82. Magee C82
  83. Saunders DI83
  84. Yeh DD13
  85. Chan DL84
  86. Felsenreich DM85
  87. Holena DN86
  88. Bawa D87
  89. Bowrey DJ88
  90. Liu DS89
  91. Chan DSY90
  92. Nag DS91
  93. Haddad DN61
  94. Corallino D92
  95. Damaskos D93
  96. Moris D94
  97. Schizas D95
  98. Korkolis DP96
  99. Bagaria DK97
  100. Adamovich DM98
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  102. Singhal D100
  103. Siddaiahsubramanya M101
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  110. Baili E39
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  165. Wilson I158
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  202. Jorgensen LN193
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Source: BJS Open Published:2024


Abstract

Background: Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the best Textbook Outcomes for non-trauma and trauma emergency laparotomy. Methods: A modified Delphi exercise was undertaken with three planned rounds to achieve consensus regarding the best Textbook Outcomes based on the category, number and importance (Likert scale of 1–5) of individual outcome measures. There were separate questions for non-trauma and trauma. A patient engagement exercise was undertaken after round 2 to inform the final round. Results: A total of 337 participants from 53 countries participated in all three rounds of the exercise. The final Textbook Outcomes were divided into ‘early’ and ‘longer-term’. For non-trauma patients the proposed early Textbook Outcome was ‘Discharged from hospital without serious postoperative complications (Clavien–Dindo ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation or death). For trauma patients it was ‘Discharged from hospital without unexpected transfusion after haemostasis, and no serious postoperative complications (adapted Clavien–Dindo for trauma ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation on or death)’. The longer-term Textbook Outcome for both non-trauma and trauma was ‘Achieved the early Textbook Outcome, and restoration of baseline quality of life at 1 year’. Conclusion: Early and longer-term Textbook Outcomes have been agreed by an international consensus of experts for non-trauma and trauma emergency laparotomy. These now require clinical validation with patient data. © The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.