{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:49:03Z","timestamp":1791568143845,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004429","name":"University of Crete","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004429","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004429","name":"University of Crete","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Emergency laparotomy (EL) is accompanied by high post\u2010operative morbidity and mortality which varies significantly between countries and populations. The aim of this study is to report outcomes of emergency laparotomy in Greece and to compare them with the results of the National Emergency Laparotomy Audit (NELA).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multicentre prospective cohort study undertaken between 01.2019 and 05.2020\u00a0including consecutive patients subjected to EL in 11 Greek hospitals. EL was defined according to NELA criteria. Demographics, clinical variables, and post\u2010operative outcomes were prospectively registered in an online database. Multivariable logistic regression analysis was used to identify independent predictors of post\u2010operative mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 633 patients, 53.9% males, ASA class III\/IV 43.6%, older than 65 years 58.6%. The most common operations were small bowel resection (20.5%), peptic ulcer repair (12.0%), adhesiolysis (11.8%) and Hartmann's procedure (11.5%). 30\u2010day post\u2010operative mortality reached 16.3% and serious complications occurred in 10.9%. Factors associated with post\u2010operative mortality were increasing age and ASA class, dependent functional status, ascites, severe sepsis, septic shock, and diabetes. HELAS cohort showed similarities with NELA patients in terms of demographics and preoperative risk. Post\u2010operative utilisation of ICU was significantly lower in the Greek cohort (25.8% vs 56.8%) whereas 30\u2010day post\u2010operative mortality was significantly higher (16.3% vs 8.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this study, Greek patients experienced markedly worse mortality after emergency laparotomy compared with their British counterparts. This can be at least partly explained by underutilisation of critical care by surgical patients who are at high risk for death.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06723-6","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T18:12:18Z","timestamp":1663265538000},"page":"130-139","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["The Hellenic Emergency Laparotomy Study (HELAS): A Prospective Multicentre Study on the Outcomes of Emergency Laparotomy in Greece"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6538-0951","authenticated-orcid":false,"given":"Konstantinos","family":"Lasithiotakis","sequence":"first","affiliation":[{"name":"Department of General Surgery School of Medicine University Hospital of Heraklion University of Crete Heraklion, Crete Greece"},{"name":"Department of General Surgery University Hospital of 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Patras University of Patras Patras Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Gouvas","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine, General Hospital of Nicosia University of Cyprus Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Kokkinos","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine, General Hospital of Nicosia University of Cyprus Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioanna","family":"Pozotou","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine, General Hospital of Nicosia University of Cyprus Nicosia Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayiotis","family":"Papatheodorou","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medicine, General Hospital of 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