Variation in outcomes between different surgical units and individual surgeons remains a challenge, according to the latest reports on emergency surgery.
Published earlier this year (April 2016), a report by the Nuffield Trust, commissioned by the Royal College of Surgeons (RCS), showed there are unacceptable differences between hospitals in outcomes for patients undergoing emergency general surgery, with death rates for major operations in this field almost 12 times higher at some Trusts than others.
The procedures performed in emergency general surgery are typically abdominal to treat conditions such as gall bladder removal, perforated gut and obstructed hernia. Patients undergoing these procedures tend to be older and more frail – frequently with other co-existing conditions. As a result, the risk of death from such surgery tends to be high, with more than one in 10 patients dying within 30 days of major emergency general surgery.
The authors looked at outcomes for patients undergoing high-risk emergency general surgery. The main problems involving this type of surgery identified by the report are:
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