BACKGROUND Intra-abdominal emergency surgery is associated with high mortality risk and long length of hospital stay. The objective of this study was to explore variations in surgery rates, the relationship between admission source and discharge destination, and whether the postoperative length of stay was related to nursing home capacity in Irish counties. METHODS Data on emergency hospital episodes for 2014-18 for patients aged over 65 years with a primary abdominal procedure code were obtained from the National Quality Assurance Improvement System. Data on population and nursing home capacity were obtained from the Central Statistics Office and the Health Information and Quality Authority. Episode rates per 100,000 were estimated for sex and age groups and compared between 26 Irish counties. The association between admission source and discharge destination was explored in terms episode numbers, length of stay and mortality. A negative binomial regression model estimated casemix adjusted excess post-operative length of stay. The correlation between excess post-operative length of stay and nursing home capacity was explored by linear regression. RESULTS Overall, 4951 hospital episodes were included. The annual surgery rate ranged from 100 episodes per 100,000 65-69 years old to 250 per 100,000 85-89 year old men. 90% of the episodes were admitted from patients' home. Four in five of these patients returned to their home while 12.7% died at hospital. The proportion of episodes where patients returned to their home reduced to two in five for those aged 85-89 years. The post-operative length of stay was 13.6 days longer (p < 0.01) for episodes admitted from home and discharged to nursing home in comparison with episodes discharged home. A negative association (p = 0.08) was found between excess post-operative length of stay and county-level nursing home capacity. CONCLUSIONS This study provides relevant information to support informed consent to surgery for patients and clinicians and to improve the provision of care to older patients presenting with intra-abdominal emergencies.

中文翻译：

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接受紧急腹部手术的老年患者的出院结果：爱尔兰公立医院出院数据的登记研究。

背景技术腹腔内急诊手术具有高死亡风险和长住院时间。本研究的目的是探讨爱尔兰各县手术率的变化、入院来源和出院目的地之间的关系，以及术后住院时间是否与疗养院容量相关。方法 2014-18 年 65 岁以上、具有初级腹部手术代码的患者住院急诊事件的数据来自国家质量保证改进系统。有关人口和疗养院容量的数据来自中央统计办公室和卫生信息和质量管理局。根据性别和年龄组估算了每 100,000 人的发病率，并在 26 个爱尔兰县之间进行了比较。从发病次数、住院时间和死亡率方面探讨了入院来源和出院目的地之间的关联。负二项式回归模型估计病例组合调整了多余的术后住院时间。通过线性回归探讨术后超长住院时间与疗养院容量之间的相关性。结果 总体而言，共纳入 4951 起医院事件。年手术率从每 10 万名 65-69 岁男性 100 例到每 10 万名 85-89 岁男性 250 例不等。90%的发作是从患者家中入院的。其中五分之四的患者返回家中，12.7% 的患者在医院死亡。对于 85 至 89 岁的患者，返回家中的发作比例减少到五分之二。与出院回家的发作相比，在家入院并出院到疗养院的术后住院时间延长了 13.6 天（p < 0.01）。术后住院时间过长与县级疗养院容量之间存在负相关（p = 0.08）。结论 本研究提供了相关信息，以支持患者和临床医生对手术的知情同意，并改善对出现腹内紧急情况的老年患者的护理服务。