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Disparities in prehospital and emergency surgical care among patients with perforated ulcers and a history of mental illness: a nationwide cohort study: a nationwide cohort study

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Title: Disparities in prehospital and emergency surgical care among patients with perforated ulcers and a history of mental illness: a nationwide cohort study: a nationwide cohort study
Authors: Julie Mackenhauer, Erika Frischknecht Christensen, Jan Mainz, Jan Brink Valentin, Nicolai Bang Foss, Peter Olsen Svenningsen, Søren Paaske Johnsen
Source: Eur J Trauma Emerg Surg
Mackenhauer, J, Christensen, E F, Mainz, J, Valentin, J B, Foss, N B, Svenningsen, P O & Johnsen, S P 2024, 'Disparities in prehospital and emergency surgical care among patients with perforated ulcers and a history of mental illness: a nationwide cohort study', European Journal of Trauma and Emergency Surgery, vol. 50, no. 3, pp. 975-985. https://doi.org/10.1007/s00068-023-02427-1
Mackenhauer, J, Christensen, E F, Mainz, J, Valentin, J B, Foss, N B, Svenningsen, P O & Johnsen, S P 2024, ' Disparities in prehospital and emergency surgical care among patients with perforated ulcers and a history of mental illness : a nationwide cohort study ', European Journal of Trauma and Emergency Surgery, vol. 50, no. 3, pp. 975-985 . https://doi.org/10.1007/s00068-023-02427-1
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: Male, Adult, Emergency Medical Services, Peptic ulcer perforation, Healthcare disparities, Denmark, Mental Disorders, Healthcare Disparities/statistics & numerical data, Time-to-Treatment/statistics & numerical data, Emergency treatment, Mental disorders, Middle Aged, Peptic Ulcer Perforation/surgery, Denmark/epidemiology, Time-to-Treatment, 3. Good health, Cohort Studies, Peptic Ulcer Perforation, Humans, Original Article, Female, Registries, Healthcare Disparities, Aged
Description: Purpose To compare patients with and without a history of mental illness on process and outcome measures in relation to prehospital and emergency surgical care for patients with perforated ulcer. Methods A nationwide registry-based cohort study of patients undergoing emergency surgery for perforated ulcer. We used data from the Danish Prehospital Database 2016–2017 and the Danish Emergency Surgery Registry 2004–2018 combined with data from other Danish databases. Patients were categorized according to severity of mental health history. Results We identified 4.767 patients undergoing emergency surgery for perforated ulcer. Among patients calling the EMS with no history of mental illness, 51% were identified with abdominal pain when calling the EMS compared to 31% and 25% among patients with a history of moderate and major mental illness, respectively. Median time from hospital arrival to surgery was 6.0 h (IQR: 3.6;10.7). Adjusting for age, sex and comorbidity, patients with a history of major mental illness underwent surgery 46 min (95% CI: 4;88) later compared to patients with no history of mental illness. Median number of days-alive-and-out-of-hospital at 90-day follow-up was 67 days (IQR: 0;83). Adjusting for age, sex and comorbidity, patients with a history of major mental illness had 9 days (95% CI: 4;14) less alive and out-of-hospital at 90-day follow-up. Conclusion One-third of the population had a history of mental illness or vulnerability. Patients with a history of major mental illness were less likely to be identified with abdominal pain if calling the EMS prior to arrival. They had longer delays from hospital arrival to surgery and higher mortality.
Document Type: Article
Other literature type
File Description: application/pdf
Language: English
ISSN: 1863-9941
1863-9933
DOI: 10.1007/s00068-023-02427-1
Access URL: https://pubmed.ncbi.nlm.nih.gov/38353716
https://vbn.aau.dk/da/publications/710cb007-ff76-4c75-a66a-676cb91077ac
http://www.scopus.com/inward/record.url?scp=85185134019&partnerID=8YFLogxK
https://doi.org/10.1007/s00068-023-02427-1
https://vbn.aau.dk/ws/files/741349865/Mackenhauer_et_al._2024_._Disparities_in_prehospital_and_emergency_surgical_care_among_patients_with_perforated_ulcers_and_a_history_of_mental_illness_-_a_nationwide_cohort_study.pdf
https://curis.ku.dk/ws/files/400875751/s00068_023_02427_1.pdf
Rights: CC BY
Accession Number: edsair.doi.dedup.....c3209374973b0185daa3c7e991c6890f
Database: OpenAIRE
Description
Abstract:Purpose To compare patients with and without a history of mental illness on process and outcome measures in relation to prehospital and emergency surgical care for patients with perforated ulcer. Methods A nationwide registry-based cohort study of patients undergoing emergency surgery for perforated ulcer. We used data from the Danish Prehospital Database 2016–2017 and the Danish Emergency Surgery Registry 2004–2018 combined with data from other Danish databases. Patients were categorized according to severity of mental health history. Results We identified 4.767 patients undergoing emergency surgery for perforated ulcer. Among patients calling the EMS with no history of mental illness, 51% were identified with abdominal pain when calling the EMS compared to 31% and 25% among patients with a history of moderate and major mental illness, respectively. Median time from hospital arrival to surgery was 6.0 h (IQR: 3.6;10.7). Adjusting for age, sex and comorbidity, patients with a history of major mental illness underwent surgery 46 min (95% CI: 4;88) later compared to patients with no history of mental illness. Median number of days-alive-and-out-of-hospital at 90-day follow-up was 67 days (IQR: 0;83). Adjusting for age, sex and comorbidity, patients with a history of major mental illness had 9 days (95% CI: 4;14) less alive and out-of-hospital at 90-day follow-up. Conclusion One-third of the population had a history of mental illness or vulnerability. Patients with a history of major mental illness were less likely to be identified with abdominal pain if calling the EMS prior to arrival. They had longer delays from hospital arrival to surgery and higher mortality.
ISSN:18639941
18639933
DOI:10.1007/s00068-023-02427-1