Adherence to and outcomes of bundle care in major abdominal emergency surgery

Introduction. Care bundles to improve post-operative outcomes after major abdominal emergency surgery have proven to be effective. This study investigated the correlation between adherence to protocol and post-operative outcomes after implementing perioperative bundle care at a single hospital. Methods. This was a retrospective cohort study. Data were collected from 2018 to 2019. Patients undergoing surgery due to major emergency abdominal pathophysiology were included. The care bundle covered the pre-, intra-and post-operative course and included 12 elements. High adherence was defined as the completion of 70% of the elements. We used the Clavien-Dindo Classification and the Comprehensive Complication Index to evaluate post-operative complications. Results. A total of 120 patients were included. High adherence was obtained in 54% of the patients. We found no difference in post-operative mortality or complications when comparing high adherence with low adherence. However, cases with high protocol adherence had a longer length of stay. Conclusions. We found no difference in mortality or complications. Patients with a high adherence had a longer hospital stay. Funding. none