Emergency Laparotomy Network
The Emergency Laparotomy Network was launched in January 2010. It is run by a steering group consisting of Dave Murray (chair, Middlesbrough), Carol Peden (Bath), Adam Pichel and Simon Varley (Manchester), Dave Saunders (Newcastle) and Iain Anderson (Salford). Membership is open to anybody involved in their care. We currently have over 160 members from over 100 acute NHS Trusts in the UK.
Patients undergoing emergency laparotomy have a poor outcome. 30-day mortality is in the region of 18%, with wide variation in mortality rates between Trusts. Provision of critical care is also very variable. Several reports (such as NCEPOD, and the Royal College of Surgeons Standards for Emergency Surgery) have highlighted concerns over the care provided to patients undergoing emergency laparotomy.
The Network's broad aims are to bring together clinicians from relevant specialties in order to improve outcome in this group of patients. The first steps in this have been to carry out a prospective multicentre audit. This finished early 2011, and recruited over 2000 patients from 37 Trusts in the UK. At present we are currently analysing the results.
This will act as a baseline for subsequent quality improvement. In addition, we are exploring developing a continuous prospective registry that aims to capture all patients undergoing emergency laparotomy.
Dr David Murray
- Saunders DI, Murray D, Pichel AC, Varley S, Peden CJ; on behalf of the members of the UK Emergency Laparotomy Network.
Variations in mortality after emergency laparotomy: the first report of the UK Emergency Laparotomy Network.
British Journal of Anaesthesia [
click here for PubMed link
- Smith C, Murray D.
Audit of emergency laparotomy in elderly patients.
Anaesthesia (Epub ahead of print - Feb 2010)
click here for PubMed link
STOP PRESS - 13th June 2012 - STOP PRESS - 13th June 2012 - STOP PRESS
HQIP award National Emergency Laparotomy Audit (NELA) to Royal College of Anaesthetists (HSRC to deliver contract)
The Health Quality Improvement Partnership (HQIP) announced in September that the National Emergency Laparotomy Audit (NELA) is one of eleven new national audits to be commissioned. The NELA and three other audits have been selected for immediate funding from the 2011-12 budget. The remaining seven audits will be supported as funds become available.
Commissioned audits were judged against a number of criteria including evidence of sub-optimal care, and the potential for significant improvements in that care, evidence of variation in care quality and evidence that the audit might reduce this inequality, presence of relevant standards and measures, and alignment with current health policy direction.
The HQIP chief executive, Robin Burgess, commented that the submitted proposal was 'felt to be clear in concept and design, and to meet the requirements of the criteria published by the National Clinical Audit Advisory Group, as well as covering a clinical area which the Department of Health feels would benefit from the introduction of a new national audit.'
The NELA will be the first national audit focusing primarily on perioperative care (as opposed to surgical factors or critical care). It is a great success for the ELN team led by Dr Dave Murray (James Cook University Hospital, Middlesbrough) and a rewarding product of the close collaboration between the ELN and the HSRC.