Abstract:
The term acute abdomen designates symptoms and signs of intra-abdominal disease
usually treated best by surgical operation. The proper management of patients with acute
abdominal pain requires a timely decision about the need for surgical operation. However,
evidence regarding this issue is limited in Hiwot Fana Comprehensive specialized University
Hospital and Jugol General Hospital , which are the study areas. Therefore, doing this study will
reduce those limitations regarding perioperative outcomes of surgically treated non-traumatic
acute abdomen and associated factors in adult patients in these two hospitals.
Objective: This study aimed to assess perioperative outcomes and associated factors among
patients undergoing laparotomy for non-traumatic acute abdomen at Hiwot Fana Comprehensive
specialized University Hospital and Jugol General Hospital from July 1 to October 31, 2024. A facility based prospective cohort study design was conducted in two public
hospitals found in Harar town, Eastern Ethiopia from July 1 to October 31, 2024. A total of 141
adult patients underwent laparotomy for non-traumatic acute abdomen. Postoperative morbidity
and mortality within 30 days of surgery were assessed. Data was collected using structured
checklists. The collected data entered into Kobo tool box and exported to STATA version 17 for
further analysis. A Kaplan-Meier analysis was used for categorical variables, and a log-rank test
was used to determine the statistically significant difference between variables. A Cox regression
analysis was conducted to identify factors associated to time to develop complications.The overall rate of unfavorable outcome was 13.5% and 29.08% of the cases developed
postoperative complications. The hazard of developing unfavorable treatment outcomes among
those with preoperative shock was 33.19 times higher than those without preoperative shock (AHR
33.191, 95% CI [1.376, 800.464]). Fever was another significant factor, with an AHR of 16.474,
95% CI [1.372, 197.756], indicating that patients with fever were more than sixteen times more
likely to develop unfavorable treatment outcomes. Age above 50 years was also another factor
with AHR of 13.950, 95% CI [1.551, 125.493]. The mortality rate in this study was 8.5%.
Conclusion: Patients who had shock, fever, and age above 50 years are at increased risk for
unfavorable perioperative outcomes. Therefore, due attention should be given to those patients
who are going for laparotomy after presented with shock and fever. Clinicians may use these
results to optimize these patients to decrease their elevated risk of serious morbidity and mortality.
