Predictors of morbidity and mortality among elderly patients undergoing emergency exploratory laparotomy at regional referral hospitals in Uganda: a multi-centre prospective study.

BACKGROUND: Elderly patients commonly pose a significant challenge, mainly in emergency settings where the time to optimize the high-risk patient with other associated co-morbidities is inadequate, which predisposes these patients to a number of complications postoperatively. There is paucity of data on predictors of morbidity and mortality among elderly surgical patients in Uganda. This study assessed the predictors of morbidity and mortality among elderly patients undergoing emergency exploratory laparotomy at Jinja, Lira, Hoima, and Fort Portal Regional Referral Hospitals. METHODS: This was a prospective observational cohort in which elderly patients (≥ 65 years) that underwent emergency exploratory laparotomy from 15th November 2024 to 14th February 2025 were enrolled and followed up until 30 days post-operatively to assess for the occurrence morbidity and mortality. The complications assessed included hemorrhage, surgical site infection, deep venous thrombosis, respiratory complications. SPSS version 26 was used for analysis, with Poisson regression done to determine the significant predictors. P < 0.05 was considered significant. RESULTS: Of the 86 participants, 29.1% were above 80 years of age. Majority were male (74.4%). Complications were seen in 25.6% of the participants. The commonest complication was surgical site infection. Mortality occurred in 10.5%. In the multivariable analysis, being older than 80 years, having DM or hypertension and having a perforation were associated with complications; delayed presentation to hospital and blood transfusion associated with mortality (P < 0.05 for all). CONCLUSION: The rates of morbidity were high. More attention is required among the elderly undergoing surgery in order to reduce the rate at which they get morbidity and mortality with emphasis on wound care. Health education and sensitization in communities should be strengthened, advocating for timely seeking of medical attention by the elderly group.