Table 1
Baseline characteristics of patients prior to exploratory laparotomy.
| Variable | Adult (n = 286) | Pediatric (n = 60) | ||
|---|---|---|---|---|
| n | % | n | % | |
| Age (mean years) | 46.5 | 9.4 | ||
| Sex | ||||
| Male | 179 | 62.6% | 45 | 75.0% |
| Female | 107 | 37.4% | 15 | 25.0% |
| Marital status | ||||
| Single | 77 | 26.9% | 56 | 93.3% |
| Married | 168 | 58.7% | 2 | 3.3% |
| Widowed | 23 | 8.0% | 0 | 0.0% |
| Divorced | 11 | 3.8% | 1 | 1.7% |
| Unknown | 7 | 2.4% | 1 | 1.7% |
| Occupation | ||||
| Laborer | 143 | 50.0% | 0 | 0.0% |
| Professional | 25 | 8.7% | 0 | 0.0% |
| Student | 30 | 10.5% | 52 | 86.7% |
| Unemployed | 21 | 7.3% | 1 | 1.7% |
| Unknown | 67 | 23.4% | 7 | 11.7% |
| Insurance status | ||||
| NHIA | 169 | 59.1% | 36 | 60.0% |
| Cash | 111 | 38.8% | 23 | 38.3% |
| Unknown | 6 | 2.1% | 1 | 1.7% |
| Hemoglobin level | ||||
| 0–11.9 | 81 | 28.3% | 25 | 41.7% |
| 12.0–14.9 | 60 | 21.0% | 19 | 31.7% |
| 15.0+ | 57 | 19.9% | 4 | 6.7% |
| Unknown | 88 | 30.8% | 12 | 20.0% |
| White blood cell count | ||||
| 0–3.99 | 13 | 4.5% | 0 | 0.0% |
| 4–10.99 | 92 | 32.2% | 21 | 35.0% |
| 11–14.99 | 52 | 18.2% | 8 | 13.3% |
| 15.0+ | 42 | 14.7% | 19 | 31.7% |
| Unknown | 88 | 30.8% | 12 | 20.0% |
Figure 1
Most common disease processes requiring exploratory laparotomy in the adult population of surgical patients at Eastern Region Hospital, Ghana.
Figure 2
Most common disease processes requiring exploratory laparotomy in the pediatric population of surgical patients at Eastern Region Hospital, Ghana.
Table 2
Surgical outcomes following exploratory laparotomy.
| Surgical Outcomes | Adult | Pediatric | p-value |
|---|---|---|---|
| (n = 286) | (n = 60) | ||
| Mortality | 12.6% | 6.7% | 0.192 |
| Length of stay (days) | 7.2 | 6.9 | 0.758 |
| 30-day readmission | 9.4% | 8.3% | 0.788 |
| SSI | 9.8% | 6.7% | 0.448 |
| Bowel resection | 21.3% | 21.7% | 0.954 |
Table 3
Perioperative mortality rates associated with the most common causes of exploratory laparotomy.
| Adult | Pediatric | ||||
|---|---|---|---|---|---|
| (Total operations = 286, Overall mortality rate = 12.6%) | (Total operations = 60, Overall mortality rate = 6.7%) | ||||
| Disease process | Total operations (n) | Mortality rate (%) | Disease process | Total operations (n) | Mortality rate (%) |
| 1. Appendicitis | 83 | 0.0% | 1. Appendicitis | 24 | 4.2% |
| 2. Obstruction | 75 | 14.7% | 2. Intussusception | 10 | 20.0% |
| 3. Perforated PUD | 42 | 14.3% | 3. Major trauma | 6 | 0.0% |
| 4. Major trauma | 17 | 17.6% | 4. Typhoid ileitis | 4 | 0.0% |
Table 4
Logistic regression modeling of mortality.
| Variable | 95% confidence interval | |||
|---|---|---|---|---|
| OR | Lower | Upper | p-value | |
| Age (years) | ||||
| 0–17 | 0.43 | 0.09 | 2.00 | 0.280 |
| 18–39 | 0.45 | 0.14 | 1.47 | 0.184 |
| 40–59 | Reference | |||
| 60+ | 3.34 | 1.25 | 8.94 | 0.017 |
| Sex | ||||
| Male | Reference | |||
| Female | 0.36 | 0.15 | 0.87 | 0.023 |
| Insurance status | ||||
| NHI | 0.41 | 0.17 | 0.96 | 0.041 |
| Cash | Reference | |||
| Diagnosis | ||||
| Appendicitis | Reference | |||
| Obstruction | 12.23 | 1.44 | 104.20 | 0.022 |
| Perforated PUD | 13.09 | 1.38 | 124.44 | 0.025 |
| Typhoid ileitis | 18.87 | 0.94 | 377.46 | 0.055 |
| Major trauma | 12.14 | 1.14 | 129.78 | 0.039 |
| Intussusception | 34.29 | 2.18 | 539.35 | 0.012 |
| Other | 24.85 | 3.03 | 203.78 | 0.003 |
| Hemoglobin level | ||||
| 0–11.9 | 0.67 | 0.26 | 1.69 | 0.394 |
| 12.0–14.9 | Reference | |||
| 15.0+ | 0.18 | 0.04 | 0.71 | 0.015 |
| White blood cell count | ||||
| 0–3.99 | 5.06 | 1.16 | 21.98 | 0.031 |
| 4–10.99 | Reference | |||
| 11–14.99 | 1.32 | 0.45 | 3.90 | 0.616 |
| 15.0+ | 2.13 | 0.67 | 6.78 | 0.199 |
Figure 3
Trends in perioperative mortality rate following exploratory laparotomy stratified by referral status for surgical patients at Eastern Region Hospital, Ghana.