EP431 - It's all in the NEWS: Can Early Warning Scores help identify severe post-operative complications in Medical Tourism patients?

Abstract Introduction Complications following surgical procedures abroad are regularly reported in news media. Often stories indicate delayed presentation to local medical services, possibly due to lack of good safety netting advice. Within the NHS, National Early Warning Score (NEWS) is used to identify those at risk of deterioration. This study aimed to determine if NEWS were associated with severity of post-operative complications. Methods A retrospective study was performed between January 2022-December 2023 at a DGH close to Gatwick Airport. The study included all emergency patients with complications following operations performed outside of UK. Data collected via electronic patient records included demographics, treatment and length of stay (LOS). Outcomes were analysed in two subgroups: NEWS 0 & NEWS ≥1. Results A total of 36 patients (mean age 40 years) were included in the study. NEWS at presentation ranged from 0-10. 25 (70%) patients had NEWS ≥1. In 100%, tachycardia (HR >90) was the abnormal parameter. NEWS ≥1 group demonstrated greater severity of complications (32% Clavien-Dindo Classification >3a vs 9%), increased rate of surgical intervention (36% vs 9%) and increased mean LOS (5.73 days vs 2.36 days). Relative Risk for severe complication was 3.96 in the NEWS ≥1 group. Conclusion Post-operative complications after surgery abroad are a significant risk to patients and a burden for local NHS services. Early presentation may lead to reduction in complex intervention and LOS. Promoting NEWS to patients going abroad for surgery may lead to improved outcomes. Advising patients to monitor their pulse after surgery is a simple message for health promotion.