There are seven specific procedures that result in 80 percent of the emergency general surgery mortalities in the United States.
We all know that there is a risk associated with undergoing any type of surgical procedure, even the most common kinds. Some you would expect to be more dangerous than others, such as brain or heart surgery. And emergency surgeries are even scarier because they are so sudden. But new research suggests that among emergency operations there are certain ones–including a few of the most frequently performed–that are potentially much more deadly than all the rest.
The study, which was conducted at Brigham and Women’s Hospital in Boston, Massachusetts, found that there are seven specific procedures that result in 80 percent of the emergency general surgery mortalities in the United States.1 Scott, John W.; et al. “Use of National Burden to Define Operative Emergency General Surgery.” JAMA Surgery. 27 April 2016. Accessed 4 May 2016. http://archsurg.jamanetwork.com/article.aspx?articleid=2516780 The scientists focused on procedures defined by the American Association of Surgery for Trauma as emergency general surgery, which mostly includes operations on organs and soft tissues around the abdominal area.
By examining a government database containing medical records, the researchers evaluated the outcomes of 421,476 emergency general surgeries from 2008 through 2011. They determined that the total death rate was 1.2 percent and that the complication rate was 15 percent among all of the procedures. But there were seven operations discovered to be responsible for an astounding four out of every five deaths in this category. These are partial colectomy (removal of a portion of the colon), small bowel resection, cholecystectomy (removal of the gallbladder), repair of a bleeding or torn ulcer, separation of abdominal organs adhering to one another, appendectomy, and laparotomy (open surgery of the abdominal cavity).
Not only were these procedures responsible for the vast majority of emergency general surgery deaths, but they also were found to result in nearly 79 percent of the complications that arise. And complications including infections, internal bleeding, and adverse reactions to anesthesia can lead to longer hospital stays, return admissions, and sometimes serious, long-term effects.
Of course, it needs to be stated that part of the problem here is unavoidable. There is an inherent urgency and inability to prepare that is the very essence of an emergency procedure. In addition, the patients who require emergency surgery are by definition in more critical, problematic states of health, often experiencing a bowel obstruction, abdominal infection, or gastrointestinal bleeding, which would immediately indicate that they are at a higher risk of difficulties during surgery than those undergoing a planned procedure. In fact, a 2008 study at the University of North Carolina, Chapel Hill showed that having an emergency surgery increases the risk of death by eight times compared to those who undergo the same procedure scheduled in advance.2 Fecho, Karamarie; et al. “Postoperative mortality after inpatient surgery: Incidence and risk factors.” Therapeutics and Clinical Risk Management. August 2008. Accessed 5 May 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621384/
But all of these issues still do not change the fact that among emergency surgeries, some are more risky than others. And on the list of most deadly, certainly removing a section of the intestine or safely disengaging abdominal organs from one another would seem to be quite a bit more dangerous than lots of other procedures, emergency or not.
What about operations like removing the gallbladder or appendix, though? These are very common procedures that we tend to think of as relatively harmless. After all, everyone knows someone who has had one of these organs removed and we rarely hear about adverse incidents. But the frequency of these surgeries is actually the reason they made the top seven list. There are approximately 325,000 appendectomies and 460,000 gallbladder removals that take place each year in America, so even if only a small percentage result in a complication or death, the number grows large enough to be a major contributor to the overall risk.
While we can’t always prevent emergency situations from occurring, in the case of many of the types of surgeries on this deadly list, taking good care of yourself can go a long way toward helping you avoid them. If you maintain a healthy weight, eat a nutritious diet, get exercise every day, detox your liver and gallbladder, and visit your doctor for regular checkups, you may never be put into a position of being admitted to the hospital for any kind of emergency care. That way, you’ll get to dodge the surgeon’s scalpel and all of the risks associated with any operation–emergency or planned.
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|1.||↑||Scott, John W.; et al. “Use of National Burden to Define Operative Emergency General Surgery.” JAMA Surgery. 27 April 2016. Accessed 4 May 2016. http://archsurg.jamanetwork.com/article.aspx?articleid=2516780|
|2.||↑||Fecho, Karamarie; et al. “Postoperative mortality after inpatient surgery: Incidence and risk factors.” Therapeutics and Clinical Risk Management. August 2008. Accessed 5 May 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621384/|