Utilisation of the Henry score in malignant bowel obstruction and characterisation of management approaches and outcomes: Experience from a New Zealand regional centre.

12049 Background: Malignant Bowel Obstruction (MBO) is a common, life-threatening complication of advanced malignancy associated with a high symptom burden and poor prognosis. Henry et al developed the Henry Score to predict 30-day mortality in MBO patients. It has not been routinely used to guide clinical decision-making regarding the management of MBO or validated in populations outside the United States of America. This study was designed to assess the utility of the Henry Score in predicting 30-day mortality in palliative patients presenting to hospital with malignant bowel obstruction in a New Zealand regional centre and to characterise the management approaches and outcomes of surgical versus non-surgical interventions. Methods: Retrospective cohort study of 235 patients admitted with MBO to Palmerston North Hospital (2010-2024). The Henry Score (0-5) incorporating five clinical and laboratory factors was calculated for each patient. Management approaches and survival outcomes were analysed. Results: Complete Henry Score data was available for 82.1% of patients. Sixty-four underwent surgical management, 171 non-surgical interventions. Median overall survival was 82.5 days (surgical: 130.5 days; non-surgical: 52 days; p=0.005). The 30-day mortality rate was 33.2%. The Henry Score demonstrated prognostic discrimination, with 30-day mortality of 28.0% for low scores (0-2) vs 43.0% for high scores (3-5) (p=0.034), and corresponding median survivals of 83 vs 39 days. Cox analysis identified hypoalbuminemia as the only factor significantly associated with mortality risk (HR 1.67, p=0.001). Māori patients had higher Henry Scores (68.2% vs 41.9% with scores ≥3, p=0.025) and shorter median survival (37 vs 97.5 days) than New Zealand European patients. Conclusions: The Henry Score effectively predicts 30-day mortality in MBO patients in New Zealand. Higher scores were associated with increased 30-day mortality, supporting the potential use of this measure for prognostication and advanced care planning. Hypoalbuminemia was the strongest predictor of mortality. Future prospective studies are needed to determine if clinical implementation of the Henry Score improves patient outcomes.