{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T04:05:53Z","timestamp":1771041953994,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Emergency laparotomy and its perioperative care is associated with high morbidity and mortality. At our institution, 30\u2010day mortality was approximately 12% in 2013\u20132017. We introduced a perioperative protocol for emergency laparotomies in 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Retrospective cohort of emergency laparotomies 2019\u20132022. Reoperations, trauma and converted laparoscopies (appendectomy and cholecystectomy) were excluded. Primary outcome was mortality at 30, 90, and 180\u00a0days. Secondary outcomes were postoperative complications (Clavien\u2013Dindo; CD) and hospital\u2010based outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six hundred eighty\u2010two patients undergoing emergency laparotomy were included. Age was 72 (IQR 23) years and 66.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0453) were aged \u2265\u00a065\u00a0years 56.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0386) were ASA class III or IV and 6.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a044) were not living at home at admission. The most frequent surgical findings were bowel obstruction (64.2%;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0438) and gastrointestinal perforations (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0134; 19.4%). Stoma creation (29.9%;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0204), adhesiolysis (28.6%;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0195), and anastomosis (27.4%;\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0187) were common. Mortality at 30\u00a0days was 6.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a047), 90\u00a0days 11.0% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a075), and 180\u00a0days 12.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a087). Mortality was higher for patients \u2265\u00a080\u00a0years than &lt; 65\u00a0years (23.9% vs. 4.4%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Mortality predictors were admission not from home (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.043), disseminated cancer (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and septic shock (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.003) or systemic inflammatory response syndrome (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.017). CD IIIb\u2013IVb occurred in 81 patients (11.9%). ICU admission was 16.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0113) and LOS 8 (IQR 7) days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mortality and complication rates after the introduction of a perioperative emergency laparotomy protocol were low despite a comorbid aged\u2010patient cohort. Particular focus on the elderly, frail, and septic patients considered for emergency laparotomy is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70209","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T17:10:22Z","timestamp":1768410622000},"page":"376-384","source":"Crossref","is-referenced-by-count":0,"title":["The Emergency Laparotomy Protocol: A Retrospective Cohort Study of Morbidity and Mortality After the Introduction of a Perioperative Protocol for Emergency Laparotomies"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8472-9629","authenticated-orcid":false,"given":"Gustaf","family":"Drevin","sequence":"first","affiliation":[{"name":"Department of Surgery and Oncology Capio S:t G\u00f6ran Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas","family":"Leo","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Capio S:t G\u00f6ran Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linn","family":"H\u00e5wi","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Capio S:t G\u00f6ran Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lovisa","family":"Str\u00f6mmer","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Capio S:t G\u00f6ran Hospital  Stockholm Sweden"},{"name":"Division of Surgery and Oncology, Department of Clinical Science Intervention and Technology Karolinska Institute  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina Helczynska","family":"Hultman","sequence":"additional","affiliation":[{"name":"Department of Surgery and Oncology Capio S:t G\u00f6ran Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010023\u201000506\u20107"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrae039"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003402"},{"key":"e_1_2_12_5_1","unstructured":"National Emergency Laparotomy Audit (NELA) 8th Patient Report of the National Emergency Laparotomy Audit (2020\u20132021) (2020)."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.0145"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjs\/znad081"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrad133"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588413x13629960048433"},{"issue":"1","key":"e_1_2_12_10_1","article-title":"A Nationwide Cohort Study of short\u2010and long\u2010term Outcomes Following Emergency Laparotomy","volume":"66","author":"Jeppesen M. 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