Analysis of Patients Who Died Following Hartmann’s Procedure

Abstract

Introduction: Hartmann’s procedure is typically performed for sigmoid colon obstruction or perforation. The primary aim of this study was to compare patients who died after a Hartmann’s procedure for obstruction and perforation. The secondary aim was to collate opinions of surgeon reviewers of any clinical events. Methods: Patients who died in Queensland, Australia after a Hartmann’s procedure, between January 2009 and December 2014, were identified from the Queensland Audit of Surgical Mortality. Results: 275 patients died; of those 56% underwent surgery for perforation, 20% for obstruction and 24% for other indications. Patients with perforation were of the same age as those with obstruction (p = 0.178) but those with perforation were more likely to be female (p = 0.059) and have a higher ASA class (p = 0.001). Patients with perforation underwent surgery one day earlier than those with obstruction (p = 0.066) but had the same postoperative length of stay as those with obstruction (p = 0.430). Surgeon reviewers identified between 1 and 7 clinical events per patient in 105 patients (38.2%). Conclusion: Patients with perforation who died following a Hartmann’s procedure were of a higher ASA class but had a shorter time to theatre compared to patients with obstruction. Clinical events were identified in one third of patients.