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However, limited evidence exists about the trajectory and key determinants of patients\u2019 health-related quality of life (QoL) following emergency abdominal surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Using the Enhanced Peri-Operative Care for High-risk patients study with measured QoL during eight months follow-up using the EQ-5D-3L questionnaire, we summarise the trajectory of patients\u2019 QoL after emergency abdominal surgery and use multivariable regression models to relate patients\u2019 demographic and clinical characteristics, pre-surgery characteristics, and time elapsed since surgery with their QoL. In further analysis we assess the contribution of post-surgery patient characteristics.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Data from 686 patients undergoing emergency abdominal surgery (50.4% female; mean age 66.6 (standard deviation (SD) 12.8) years; 50.1% with intestinal obstruction as indication for surgery), with QoL measurements were analysed. Shortly after surgery (mean days 7.59 (SD 7.48)), the mean EQ-5D-3L QoL utility score was 0.21 (SD 0.46), which improved among survivors to 0.74 (SD 0.31) in the medium- to long-term (i.e., three to eight months) following surgery. Patient\u2019s sex and preoperative risk of mortality were key determinants of QoL shortly after surgery. In addition to time since surgery, patient\u2019s sex, Charlson Comorbidity index, ASA physical status and indication for surgery were key pre-surgery predictors of QoL in the medium- to long-term post-surgery. From post-surgery characteristics, duration of hospital admission for index surgery and further days in hospital within 30 days prior to QoL measurement were key further determinants of QoL in the medium- to long-term.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Individual patient, surgery, and recovery characteristics determine QoL post-emergency abdominal surgery and can help inform clinician-patient discussions and assessments of value of abdominal surgery interventions.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s13017-025-00643-1","type":"journal-article","created":{"date-parts":[[2025,9,2]],"date-time":"2025-09-02T10:07:52Z","timestamp":1756807672000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Health-related quality of life after emergency abdominal surgery"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3906-2316","authenticated-orcid":false,"given":"Vladimir Sergeevich","family":"Gordeev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4850-6567","authenticated-orcid":false,"given":"Esubalew","family":"Assefa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4373-5934","authenticated-orcid":false,"given":"Rupert","family":"Pearse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5048-1784","authenticated-orcid":false,"given":"Mark","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0951-1304","authenticated-orcid":false,"given":"Borislava","family":"Mihaylova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,2]]},"reference":[{"key":"643_CR1","unstructured":"NELA project team. 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Study was exempt from individual patient consent in accordance with Sect.\u00a0251 of the National Health Services Act 2006.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"VSG, EA, and BM declare no conflict of interest. RP has received research grants and\/or honoraria from Edwards Lifesciences, Intersurgical, and GlaxoSmithKline and is a member of the editorial board of the British Journal of Surgery. ME has received honoraria from Edwards Lifesciences.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"73"}}