WP3.11 - Emergency laparotomies in the elderly: long term outcomes

Abstract Aims Emergency laparotomy is understood to be high risk in the elderly, but there is limited long term outcome data. This study assesses long term outcomes in the elderly including: survival and functional outcomes. Methods Patients, aged 80 and above, were identified from the prospective National Emergency Laparotomy Audit (NELA) database, who underwent surgery between: January 2020 and August 2023 at Torbay Hospital. Surviving patients were followed up. Results 132 cases were undertaken (22% of total emergency laparotomies performed). Mean age was 85 years. Most common ASA was 3. Preoperatively, the most common clinical frailty score was 6, i.e., moderately frail and 89% were living at home without care. The most common procedure was adhesiolysis. 50% of patients were admitted to intensive care. 5 patients returned to theatre. 17% were readmitted within 30 days of discharge. The most common reason for was fall. 20% of patients did not survive to discharge. 38% did not survive to August 2023. After the procedure 46% of patients were able to return home independently; 5% had care at home; 26% were discharged to community hospital and 2% to care home. By January 2024 61% of survivors were living independently at home with no functional decline. Most commonly, patients needed support with bathing/stairs/dressing (37%). 11% of respondents were completely dependent. Conclusion Emergency laparotomy confers a significant mortality, morbidity and risk to an elderly patient’s long term functional status. We believe this information is essential for surgical decision making and the consent process.