Terje Jansson Timan: Reduced mortality after acute abdominal surgery
Mortality rates are high among patients in need of emergency major abdominal surgery. In 2018, a new structured approach was implemented at Norra Älvsborg County Hospital to care for these patients. Terje Jansson Timan’s thesis reveals a reduction in mortality of over 25 percent.
TERJE JANSSON TIMAN
Dissertation Defense: November 24, 2023 (click for details)
Doctoral Thesis: Morbidity and mortality following Standardised perioperative Management of patients operated with acute Abdominal Surgery in a High-risk emergency setting
Research Area: Surgery
Sahlgrenska Academy, The Institute of Clinical Sciences
Perforation or obstruction in the intestines, or intra-abdominal bleeding – these are common reasons why patients need to undergo acute major abdominal surgery.
“These patients face high mortality rates and often experience complications. This situation results in immense suffering for the patients and their families,” says Terje Jansson Timan, a specialist in anesthesiology and intensive care at Norra Älvsborg County Hospital (NÄL) in Trollhättan, western Sweden.
A study of 1,300 patients
In Denmark and England, the care for this patient group has been improved by a standardized approach in their management. Inspired by these developments, Terje Jansson Timan and his colleagues in Trollhättan devised a similar systematic approach.
“My doctoral project is about how we’ve tried to enhance patient care by implementing a more systematic and standardized approach for the healthcare teams. Our study involved over 1,300 patients.”
Reduced ICU stay
What are the most crucial research findings?
“The study demonstrates that mortality decreased by over 25 percent when healthcare teams adopted the systematic standardized care. Additionally, this approach enables earlier hospital discharge for patients and reduces the need for extended stays in the intensive care unit.”
What has been enjoyable and challenging about this doctoral project?
“This is, in a way, a management study. Initially, it was quite a challenge to make the new approach work, ensuring that everyone would use the systematic standardized clinical protocol when caring for these patients,” says Terje Jansson Timan, and he adds:
“It was gratifying to see that we could implement this. Later on, it was incredibly satisfying to discover that it seems to have greatly improved the outcomes for our patients.”
More hospitals follow
Do you know if other hospitals in Sweden are adopting similar approaches to care for emergency patients needing major abdominal surgery?
“Alongside our study, international guidelines with strong recommendations for standardized care have been published this year. I’m aware that several Swedish hospitals are currently in the process of implementing protocol-based standardized care for these patients, and that’s a positive development. However, there is still much work to be done for all Swedish emergency hospitals to follow the new international guidelines.”
How are you working to spread this knowledge, given the success of the approach?
“We maintain close contact with several hospitals across Sweden that are either in the initial phases of implementation or seeking insights into our experience with introducing protocol-based standardized care. Additionally, our study has been presented at numerous national and international conferences.”
Text: Jakob Lundberg
Terje Jansson Timan is also a researcher at the Center for Disaster Medicine at the University of Gothenburg, a knowledge hub commissioned by the Swedish National Board of Health and Welfare. The center conducts research, development, and education in the field of disaster medicine and healthcare during times of crisis and war.
“The research in my thesis has some relevance to disaster medicine, particularly since it involves patients undergoing major emergency abdominal surgery due to traumatic injuries. This is what we term as primary trauma laparotomies,” he says.