Year: 2024
Type: article
Study design: Observational Study
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.
Source: British journal of surgery
Authors: Emily Hale, Heather Davis, Sena Sert, Kirk Bowling
Language: English
Topic: Frailty in Older Adults
Subfield: Geriatrics and Gerontology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4402376030