OUT- COME OF EMERGENCY LAPAROTOMY IN SOLOMON ISLANDS.

Keywords: Emergency, Surgery, Laparotomy, Outcome, Solomon Islands.
Background:
Emergency laparotomy is a common surgical procedure and the outcomes are associated with higher morbidity and mortality even in the best health care service. In the Low and Middle Income Countries (LMIC), there is still paucity of evidence on patient outcomes after emergency laparotomy.
This study from the Pacific Islands LMIC has been carried out to assess patient outcome after emergency laparotomy and associated factors leading to the outcome in our set-up.
Method:
This is a prospective Observational Study. All Patients undergoing emergency laparotomy at the Solomon Islands National Referral Hospital from February 2020 to August 2020 were included. Patient data were retrieved from patient Medical records immediately after surgery and followed through until discharge. The primary measured out-comes were Mortality and Morbidity.
Results:
A total of 53 patients were collected and the adjusted 30-day mortality and morbidity rates were 13.25 and 37.7% respectively for all patients. The mean age was 27.9 and 12 (22.6%) were in the paediatrics age group (1-12yrs). Statistically significant associated pre-operative factors included ASA (p = <0.001), q-SOFA Score on admission (p = 0.010) and BMI (p = 0.015). Intra-operatively, peritoneal soiling had significant on the out-come of the patients (p = 0.015).
Conclusion:
This study confirms that emergency laparotomy in the Solomon Islands carries a high mortality and morbidity. This calls for a national quality improvement in perioperative care in our hospital.