Patients on chronic immunosuppression face higher mortality after emergency surgery, especially with complex procedures.

• 5.1% of over 30,000 patients studied were on chronic immunosuppression, showing a 2.3% higher mortality risk (p<0.001).
• Increased complications, infections, and readmission rates were also observed for this group.

Surgeons should be cautious with emergency exploratory laparotomy in these patients while simpler procedures like appendectomy can be performed safely.

• No mortality risk increase was noted for appendectomy, cholecystectomy, or small bowel obstruction surgeries.