In-hospital mortality in acute abdominal diseases in the Central Federal District of Russia depending on availability of laparoscopic procedures

Sazhin VP, Panin SI, Sazhin IV, Nuzhdikhin AV, Yudin VA, Podyablonskaya IA, Kuznetsov AA. In-hospital mortality in acute abdominal diseases in the Central Federal District of Russia depending on availability of laparoscopic procedures. Pirogov Russian Journal of Surgery. 2023;(6):13‑20. (In Russ.)
https://doi.org/10.17116/hirurgia202306113

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To study in-hospital mortality in acute abdominal diseases in the Central Federal District and compared effectiveness of laparoscopic and open surgeries.

MATERIAL AND METHODS

The study was based on the previous data for 2017—2021. The odds ratio (OR) was used to assess significance of between-group differences.

RESULTS

The absolute number of deceased patients with acute abdominal diseases increased significantly and exceeded 23 thousand in the Central Federal District between 2019 and 2021. This value approached 4% for the first time over the last 10 years. In-hospital mortality from acute abdominal diseases in the Central Federal District increased for 5 years and reached maximum value in 2021. The greatest changes occurred in perforated ulcers (mortality increased from 8.69% in 2017 to 14.01% in 2021), acute intestinal obstruction (from 4.7% to 9.0%) and ulcerative gastroduodenal bleeding (from 4.5% to 5.5%). In other diseases, in-hospital mortality is lower, but trends are similar. Laparoscopic surgeries are common in acute cholecystitis (71-81%). At the same time, in-hospital mortality is significantly lower in regions with more active use of laparoscopy (0.64% and 1.25% in 2020; 0.52% and 1.16% in 2021). Laparoscopic surgeries are significantly less actively used for other acute abdominal diseases. We analyzed availability of laparoscopic surgeries using the «Hype Cycle». Percentage range of introduction reached conditional «productivity plateau» only in acute cholecystitis.

CONCLUSION

Most regions are stagnating in laparoscopic technologies for acute appendicitis and perforated ulcers. Laparoscopic operations are actively used for acute cholecystitis in most regions of the Central Federal District. Annual increase in the number of laparoscopic operations and their technical improvement are promising in reducing in-hospital mortality associated with acute appendicitis, perforated ulcers and acute cholecystitis.

Keywords:

laparoscopic surgery

open surgery

acute appendicitis

perforated ulcer

acute cholecystitis

in-hospital mortality

Authors:

Sazhin V.P.

Vishnevsky National Medical Research Center of Surgery;
Pavlov Ryazan State Medical University

ORCID: 0000-0001-9452-1656

Panin S.I.

Volgograd State Medical University

SPIN RSCI: 8303-5413
Scopus AuthorID: 57198338379
ORCID: 0000-0003-4086-2054

Sazhin I.V.

Pirogov Russian National Research Medical University

ORCID: 0000-0002-8073-6717

Nuzhdikhin A.V.

Tula Regional Clinical Hospital

ORCID: 0000-0001-7216-8206

Yudin V.A.

Pavlov Ryazan State Medical University

ORCID: 0000-0001-6385-7413

Podyablonskaya I.A.

Pavlov Ryazan State Medical University

ORCID: 0000-0002-6779-666X

Kuznetsov A.A.

Volgograd State Medical University

SPIN RSCI: 8450-2088
Scopus AuthorID: 57653858600
ORCID: 0000-0002-7026-1746

Received:

16.01.2023

Accepted:

12.02.2023

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