Background: Emergency laparotomy with bowel resection and anastomosis is associated with significant morbidity and mortality. Identifying predictors of morbidity can improve patient outcomes and guide perioperative management. Methods: This prospective observational study was conducted at a tertiary care hospital over 27 months. Patients undergoing emergency laparotomy with bowel resection and anastomosis were included. Demographic details, clinical parameters, intraoperative findings, and postoperative complications were recorded. Predictors of morbidity were analyzed using univariate and multivariate logistic regression. Results: A total of 200 patients were included. Postoperative morbidity was observed in 60% (n=120) of patients. Independent predictors of morbidity included advanced age (OR 2.1, p=0.01), high ASA score (OR 3.5, p<0.001), presence of sepsis (OR 2.8, p=0.002), prolonged operative time (OR 2.3, p=0.008), and hypoalbuminemia (OR 2.6, p=0.005). The 30-day mortality was 12% (n=24). The most common complications were surgical site infection (32%), anastomotic leak (18%), and pneumonia (14%). Conclusion: Emergency laparotomy with bowel resection and anastomosis has high morbidity. Identifying and optimizing predictors such as age, ASA score, sepsis, operative time, and nutritional status can help improve surgical outcomes.

Emergency laparotomy