TPW 5.05 The Impact of Centralisation of Emergency Surgical Services on Emergency Laparotomy Outcomes

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ID: 323953
2026
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Abstract
Abstract Background Centralisation of hospital services aims to focus resources to high volume centres. The Southern Health and Social Care Trust (SHSCT) centralised its Emergency General Surgery (EGS) service to Craigavon Area Hospital (CAH) permanently in 2024. Aims This study investigates whether centralisation impacted mortality rates in patients undergoing emergency laparotomy. Methods Retrospective study was performed using SHSCT National Emergency Laparotomy Audit (NELA) data & local care records. Patients were grouped into those attending A&E in CAH, with direct access to General Surgery, and those attending A&E in Daisy Hill Hospital (DHH), where they required transfer. Statistical analysis was performed using t-test and chi-square analysis using GraphPad. A p value of <0.05 was deemed significant. Results 217 patients were identified, 30 were excluded leaving 187 patients for inclusion (CAH n=133, DHH n=54). There was no difference in age (p=0.482), gender (p=0.384) and NELA risk score (p=0.532) at time of laparotomy. There was no difference in mortality (p=0.844), length of stay (p=0.243) or post operative care requirement (p=0.260). Those from DHH had a longer stay in ICU (p=0.050). Time to CT report was faster for DHH (p <0.001) which reflected a quicker decision to admit from DHH (p=0.004). Due to transfer time, there was a difference between the time taken from A&E decision to admit and the patient’s arrival on the surgical ward (p=0.001). Conclusion Centralisation of emergency general surgery within the Southern Health and Social Care Trust had no significant difference on mortality outcomes for patients undergoing emergency laparotomy.
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Authors Kyle Walsh, Mehaab Jaffer, David Mark, Adrian Neill, Mark Taylor
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.347
URL
https://doi.org/10.1093/bjs/znag087.347
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