ESORT: Evaluating the effectiveness of emergency surgery for patients with acute conditions

This study is evaluating the relative effectiveness and cost-effectiveness of emergency general surgery compared to non-operative strategies for patients with acute conditions. We are using data from Hospital Episode Statistics for patients who present as emergency admissions to NHS Trust hospitals in the UK.

An advanced quantitative method (flexible instrumental variable approach) is being used to address the key methodological challenge of confounding by indication, which arises when there are important differences in prognosis between the patient groups under comparison. The research will provide policy-relevant estimates of the relative benefits, harms and cost-effectiveness of emergency general surgery according to patient subgroups.

This study is part of the NIHR ESORT (Emergency Surgery – Or noT) project, which aims to determine the effectiveness and cost-effectiveness of emergency surgery for patients with common acute conditions presenting as emergency hospital admissions. 

For more detail on the range of work done, click these links:

• How does a local instrumental variable method perform across settings with instruments of differing strengths? A simulation study and an evaluation of emergency surgery
• Adapting Patient and Public Involvement processes in response to the Covid-19 pandemic
• Impact of the first wave of COVID-19 on outcomes following emergency admissions for common acute surgical conditions: analysis of a national database in England
• Effectiveness of emergency surgery for five common acute conditions: an instrumental variable analysis of a national routine database
• Variation in the rates of emergency surgery amongst emergency admissions to hospital for common acute conditions
• Emulating target trials with real-world data to inform health technology assessment: findings and lessons from an application to emergency surgery
• Local instrumental variable methods to address confounding and heterogeneity when using Electronic Health Records: an application to emergency surgery

London School of Hygiene and Tropical Medicine (LSHTM)