PERIOPERATIVE OUTCOMES AND ASSOCIATED FACTORS AMONG ADULT PATIENTS UNDERGOING LAPAROTOMY FOR NON-TRAUMATIC ACUTE ABDOMEN IN EASTERN ETHIOPIA: A MULTI-CENTER PROSPECTIVE COHORT STUDY josephsol87@gmail.com

PW07-05

PERIOPERATIVE OUTCOMES AND ASSOCIATED FACTORS AMONG ADULT PATIENTS UNDERGOING LAPAROTOMY FOR NON-TRAUMATIC ACUTE ABDOMEN IN EASTERN ETHIOPIA: A MULTI-CENTER PROSPECTIVE COHORT STUDY

2

Ethiopia

Oral or Poster

Acute abdomen refers to intra-abdominal conditions often requiring surgical intervention. Timely surgical decisions are critical, especially in cases of non-traumatic acute abdomen, a common surgical emergency. Despite the frequency of laparotomy in such cases, data on perioperative morbidity and mortality remain scarce in low-resource countries like Ethiopia. This study aims to identify factors associated with adverse outcomes following laparotomy for non-traumatic acute abdomen in eastern Ethiopia.

A prospective cohort study was conducted in two public hospitals in Eastern Ethiopia from July to October 2024. A total of 141 patients underwent laparotomy for non-traumatic acute abdomen were followed for 30 days postoperatively. Kaplan-Meier survival curves for categorical variables, and log-rank tests were applied to determine statistical significance. Cox regression was used to identify independent predictors of time to complication onset.

Among the 141 patients, 29.08% developed postoperative complications, and 13.5% experienced unfavorable outcomes, including death. The mortality rate was 8.5%. Preoperative shock was the strongest predictor of poor outcomes (AHR 33.191; 95% CI [1.376, 800.464]). Fever at presentation significantly increased risk (AHR 16.474; 95% CI [1.372, 197.756]), as did age over 50 years (AHR 13.950; 95% CI [1.551, 125.493]). These factors were independently associated with increased perioperative risk.

Shock, fever, and age above 50 years are key predictors of poor perioperative outcomes following laparotomy for non-traumatic acute abdomen. These findings underscore the importance of early identification and optimization of high-risk patients to reduce morbidity and mortality. Clinicians should prioritize preoperative stabilization and tailored perioperative care for vulnerable groups.