Background: Emergency general surgery (EGS) involves care of a patient's often previously unknown disease in the setting of an unplanned interaction with the healthcare system. This leads to challenges collecting and interpreting patient reported outcome measures (PROMs).
Methods: We performed a qualitative and mixed methods study using semi-structured interviews during the index hospitalization and at 6-12 months to capture peri-operative patient experiences. We compared interview findings to clinical characteristics.
Results: Among 30 patients, two-thirds reported feeling no choice but to pursue emergency surgery with many reporting exclusion from decision-making. Females reported these themes more commonly. Patients with minor complications less frequently reported trust in their team and discussed communication issues and delays in care (all p < 0.05). Patients with major complications more frequently reported confidence in their team and gratefulness, but also communication limitations (all p < 0.05). Patients not admitted to the ICU more frequently discussed good communication and expeditious treatment.
Conclusions: PROMs developed for EGS patients should consider patient outcomes and reflections that they felt excluded from decision-making. Severity of complications may also differentially impact PROMs.
Keywords: Communication; Decision-making; EGS; Mixed methods; PROMs.
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