NIHR133467Sponsored by the
University of Nottingham
POP-I · Emergency Laparotomy sites5 August 2026
Two years at the top,
and now it's all square
St James University Hospital have just randomised again, drawing level with the New Royal Liverpool University Hospital at the head of the Emergency Laparotomy table. It is the first time Liverpool have shared top spot since August 2024.
New Royal Liverpool
University Hospital
St James
University Hospital
Joint top · Emergency Laparotomy
Cumulative randomisations
■ Liverpool ■ St James
Liverpool set the standard
Liverpool randomised their first POP-I participant in April 2024 and took top spot on 13 August 2024. They then held it outright for 722 consecutive days, and were the first Emergency Laparotomy site to reach 10, 20 and 30. Every other site has been chasing a target they set.
Theirs is the hardest kind of recruitment to sustain: steady, across 16 separate months and more than two years, including a five-randomisation February this year. They remain joint top today.
How St James closed it
St James opened 13 months later, in May 2025, and by July 2025 were 15 behind. Then came a remarkable October: nine randomisations in a single month, still the best month by any Emergency Laparotomy site.
Since 1 June they have added eight more, turning a seven-participant gap into a dead heat in nine weeks. Catching this particular site is no small thing.
722
days Liverpool spent alone at the top, until today
15 → 0
the gap St James have closed since July 2025
8
St James randomisations since 1 June alone
45%
of all POP-I EmLap randomisations come from these two sites
Now the interesting part
Two sites, level on 31, and no obvious tie-breaker. Liverpool have the deepest track record in the trial and a habit of recruiting in clusters, so one good fortnight puts them straight back in front, and they have done it repeatedly. St James have the momentum and, on current form, the faster underlying rate.
Between them these two sites have delivered close to half of every Emergency Laparotomy randomisation in POP-I. That is a real contribution from both, and the next few months should be worth watching. Whoever finishes on top, the trial is the one that benefits, so keep them coming.