MTP2.16 Are we calculating frailty score along with NELA risk assessment for emergency laparotomy patients above 65y and referring them for elderly care review post operatively for better outcome - as per NELA recommendation

Aim To create awareness among the surgeons to take into account the frailty score of the patients to assess the real risk for emergency laparotomy. NELA risk score does not take frailty into account while assessing the risk. According to the NELA findings, frailty doubles the risk of mortality amongst the patients aged 65 and above from 6% to 13% (doubles). NELA also recommends geriatric team to review all the elderly, frail and vulnerable patients postoperatively as that have shown better outcomes postoperatively in national audits. Method There were a total of 40 patients who fit the criteria of inclusion which was emergency laparotomy above the age of 65 which we collected from the NELA website performed by our department. We also looked into consultation, admission, progress and operative notes for more information. Results In the first cycle the total number of patients whose frailty scores were calculated was 53.8% with surgical team documenting none while other specialities like ICU, A&E and anaesthesia doctors documenting it usually. 7.7% of the patients were referred to elderly care postoperatively. In the 2nd cycle, the outcomes were better with 85% of the patients calculated for frailty scores, total operated 40 patients. Out of the 85%, only 5% documentation were by the surgeons and rest by the other specialities. Geriatric referral did not show great improvement with only 10% of referrals postoperatively. Conclusion There were some improvements in all the three areas Requires regular discussion and awareness Think CFS whenever you calculate NELA