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Benefits of laparotomy audit revealed at conference

Dr Hare discussed the findings of the 2017 NELA report during her keynote address at the National Office of Clinical Audit (NOCA) Annual National Conference last week.

Almost 30,000 laparotomies are carried out each year across England and Wales and 24,897 of these were entered into the latest audit. The audit results showed improvements in care have reduced patients’ average hospital stay from 19.2 days in 2013, to 16.6 days in 2016. The report also showed that since 2013, the national 30-day mortality rate has fallen from 11.8 pet cent to 10.6 per cent.

Dr Hare said the figures demonstrate what a success the initiative has been.

“As a result of the hard work of the 187 teams across the country… the number of standards that are being met year-on-year has improved,” she reported.

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Dr Sarah Hare, NELA

Dr Hare said that the assessment of risk is vital in carrying out procedures on these patients, given the nature of laparotomies — most patients included in the audit to date were categorised as high-risk.

“The question now is, should we be treating all these patients as high-risk patients?” she stated.

The NELA data has allowed the development of a bespoke emergency laparotomy risk assessment tool to predict the risk of 30-day mortality.

“So our data has been really powerful in negotiating, or trying to negotiate, what care we can give these patients, what beds we can provide, or how many consultants to have, because we can say we know now that the majority of our patients who have emergency lap surgery warrant the level of critical care and consultant-led care. So we are using the data to drive and shape the health service.”

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