PDF(Pubmed)
Abstract：
Futile is defined as \'the fact of having no effect or of achieving nothing\'. Futility in medicine has been defined through seven guiding principles, which in the context of emergency surgery, have been relatively unexplored. This scoping review aimed to identify key concepts around surgical futility as it relates to emergency laparotomy.
Using the Arksey and O\'Malley framework, a scoping review was conducted. A search of the Cochrane Library, Google Scholar, MEDLINE, and Embase was performed up until 1 November 2021 to identify literature relevant to the topic of futility in emergency laparotomy.
Three cohort studies were included in the analysis. A total of 105 157 patients were included, with 1114 patients reported as futile. All studies were recent (2019 to 2020) and focused on the principle of quantitative futility (assessment of the probability of death after surgery) within a timeline after surgery: two defining futility as death within 48 hours of surgery and one as death within 72 hours. In all cases this was derived from a survival histogram. Predictors of defined futile procedures included age, level of independence prior to admission, surgical pathology, serum creatinine, arterial lactate, and pH.
There remains a paucity of research defining, exploring, and analysing futile surgery in patients undergoing emergency laparotomy. With limited published work focusing on quantitative futility and the binary outcome of death, research is urgently needed to explore all principles of futility, including the wishes of patients and their families.
Using the Arksey and O\'Malley framework, a scoping review was conducted. A search of the Cochrane Library, Google Scholar, MEDLINE, and Embase was performed up until 1 November 2021 to identify literature relevant to the topic of futility in emergency laparotomy.
Three cohort studies were included in the analysis. A total of 105 157 patients were included, with 1114 patients reported as futile. All studies were recent (2019 to 2020) and focused on the principle of quantitative futility (assessment of the probability of death after surgery) within a timeline after surgery: two defining futility as death within 48 hours of surgery and one as death within 72 hours. In all cases this was derived from a survival histogram. Predictors of defined futile procedures included age, level of independence prior to admission, surgical pathology, serum creatinine, arterial lactate, and pH.
There remains a paucity of research defining, exploring, and analysing futile surgery in patients undergoing emergency laparotomy. With limited published work focusing on quantitative futility and the binary outcome of death, research is urgently needed to explore all principles of futility, including the wishes of patients and their families.
摘要：
徒劳被定义为“没有效果或一无所获的事实”。通过七个指导原则定义了医学中的效用，在急诊手术的背景下，相对未被探索。此范围审查旨在确定与紧急剖腹手术有关的手术无效性的关键概念。
使用Arksey和O\'Malley框架，进行了范围审查。搜索Cochrane图书馆,谷歌学者，MEDLINE,直到2021年11月1日进行了Embase,以确定与紧急剖腹手术无效主题相关的文献.
分析中包括三个队列研究。共纳入105157名患者，1114名患者报告为徒劳。所有研究都是最近的研究（2019年至2020年），并侧重于手术后时间表内的定量徒劳性原则（评估手术后死亡的可能性）：两项将徒劳性定义为手术后48小时内死亡，一项定义为72小时内死亡。在所有情况下，这都是从生存直方图得出的。定义的徒劳程序的预测因素包括年龄，入学前的独立程度，外科病理学,血清肌酐,动脉乳酸，和pH。
定义的研究仍然很少，探索,并分析了急诊剖腹手术患者的徒劳手术。由于有限的出版工作集中在数量上的徒劳和死亡的二元结果，迫切需要研究来探索所有徒劳的原则，包括患者及其家属的意愿。
使用Arksey和O\'Malley框架，进行了范围审查。搜索Cochrane图书馆,谷歌学者，MEDLINE,直到2021年11月1日进行了Embase,以确定与紧急剖腹手术无效主题相关的文献.
分析中包括三个队列研究。共纳入105157名患者，1114名患者报告为徒劳。所有研究都是最近的研究（2019年至2020年），并侧重于手术后时间表内的定量徒劳性原则（评估手术后死亡的可能性）：两项将徒劳性定义为手术后48小时内死亡，一项定义为72小时内死亡。在所有情况下，这都是从生存直方图得出的。定义的徒劳程序的预测因素包括年龄，入学前的独立程度，外科病理学,血清肌酐,动脉乳酸，和pH。
定义的研究仍然很少，探索,并分析了急诊剖腹手术患者的徒劳手术。由于有限的出版工作集中在数量上的徒劳和死亡的二元结果，迫切需要研究来探索所有徒劳的原则，包括患者及其家属的意愿。
