Emergency Medicine Perspectives on Quality of Life Outcomes After Emergency Laparotomy: A Systematic Review.

Emergency laparotomy is a life-saving intervention for acute abdominal conditions, yet its impact on patients' long-term quality of life (QOL) remains poorly understood. This systematic review synthesizes evidence on QOL outcomes following emergency laparotomy, with a focus on emergency medicine perspectives, including recovery trajectories, influencing factors, and implications for clinical practice. A comprehensive search of PubMed/Medline, Embase, Web of Science, and Scopus was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In total, 11 studies were included, encompassing prospective and retrospective cohorts, cross-sectional surveys, and one randomized controlled trial. The risk of bias was assessed using the Newcastle-Ottawa Scale and the Cochrane Risk of Bias tool. Narrative synthesis was performed due to heterogeneity in QOL measures. Key findings revealed significant variability in QOL recovery. Survivors of peritonitis without malignancy reported acceptable QOL, while cancer and advanced age predicted worse outcomes. Chronic pain affected 19-45% of patients, particularly after small bowel obstruction surgery, and was linked to long-term functional impairment. Laparoscopy improved QOL in elderly patients compared to laparotomy. Frailty and prolonged hospitalization were associated with declines in physical and social functioning. Patient-reported outcome measures were feasible in emergency settings but highlighted unmet needs in psychological and social recovery. Emergency laparotomy significantly impacts QOL, with recovery shaped by surgical approach, comorbidities, and postoperative pain. Standardized QOL assessment, integrated multidisciplinary care, and targeted rehabilitation are needed to optimize long-term outcomes. Future research should prioritize prospective studies with uniform QOL metrics to guide patient-centered interventions.