Emergency Laparotomy-Ninth Patient Report (NELA)
The National Emergency Laparotomy Audit (NELA) has published its Ninth Patient Report, covering December 2021 to March 2023.
It finds that there has been a deterioration in performance since last year in several key areas. In many others there has been insufficient improvement over repeated audit cycles and annual reports. Examples of a decline in performance include preoperative engagement with consultant anaesthetists and intensivists, and the proportion of patients who arrive in theatre within stated timescales from the time of decision to operate. Importantly, this report also shows a corresponding lack of further improvement of some key outcome measures including mortality and postoperative length of stay.
The report contains a number of key messages, including:
- Patients with significant and time-sensitive intra-abdominal pathologies, including those with suspected sepsis, frequently did not receive timely care consistent with published guidance
- The majority of older patients and those living with frailty do not receive expert multidisciplinary care after emergency laparotomy
- There is hospital-level variation in risk-adjusted mortality. Additionally, there is higher mortality amongst those from more deprived quintiles in each nation
- 14% of high-risk patients did not receive immediate postoperative critical care contrary to published guidance.
It also contains recommendations to address these findings, as well as opportunities for quality improvement.
Read the full report: You can see all key findings and read the report in full by clicking on the link below.
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