Preoperative national early warning score and requirement of organ support in emergency laparotomy cases: An observational study

Abstract

Introduction: Emergency laparotomy cases may require admission in critical care unit for mechanical ventilation, inotropes or both. Different scores are being used for the prediction of the clinical severity. National early warning score can be used preoperatively to assess the clinical severity and postoperative care planning. This study aimed to find out the association of this early warning score with the requirement of the organ supports in the emergency laparotomy cases.

Methodology: This prospective observational study was conducted in patients undergoing emergency laparotomy in Bir Hospital for september 1 2019 to August 30 2020. The patients under mild, moderate and severe National early warning score were observed for the requirement of any organ support like mechanical ventilator, inotropes or renal support like dialysis during perioperative period. The association of the requirement of the organ support with the severity of the early warning score was calculated with binary logistic regression analysis.

Results: The total of 103 patients were observed. The odds of the requirement of mechanical ventilator was ODDS ratio of 14.722[95% CI between 4.437to 48.846, (p<0.001)] and inotropic support was ODDs ratio of 14.722 [95% CI between 4.437-48.846, p<0.001)] when mild cases were compared with the severe cases. The overall mortality in this study is 3.9%, as out of 103 patients, four patients died within seven postoperative days.

Conclusion: This study concludes that the emergency laparotomy cases with the severe early warning score are associated with the requirement of the organ supports.