Transplant patients are at higher risk of serious sequelae from medical and surgical interventions. However, there is a dearth of data on the incidence and burden of emergency general surgery (EGS) in transplant patients. Thus, a study was performed to identify predictors of outcomes in transplant patients with EGS needs. The Nationwide Inpatient Sample (2007-2011) was queried for adult patients (aged ≥16 years) who underwent abdominal visceral transplantation. Further query was done for a secondary diagnosis of an American Association for the Surgery of Trauma-defined EGS condition. Outcome measures were mortality, complications, length of stay, and cost of care.

In total, 35,573 transplant patients were identified. Of these, 10,676 (30%) developed an EGS condition. Resuscitation (7.7%), intestinal obstruction (7.3%), biliary conditions (3.9%), and hernias (3.2%) were the most common EGS conditions. It is noteworthy that patients with public insurance, those in the highest income quartile, and those treated at larger hospitals were less likely to develop an EGS condition (P < 0.05). Patients with an EGS condition had a ninefold greater risk of mortality and a threefold higher probability of developing complications (odds ratio [95% confidence interval (CI)]: 9.21 [1.80-10.89] and 3.17 [3.02-3.34], respectively). Moreover, transplant patients after EGS had a longer risk-adjusted length of stay and cost of index hospitalization. On the basis of this data, it was suggested that transplant patients fare poorly after developing an EGS condition.

Source: J Surg Res. 2020 Jan;245:315-320.