SP2.01 A Three Nation Patient Experience of Emergency Laparotomy Study (PEEL)

Aims National initiatives such as NELA have successfully resulted in dropping mortality rates after Emergency Laparotomy. However, for those patients who survive many struggle with worsening frailty, new multimorbidity and loss of independence. Further research focussing on these survivors is key to improving our understanding of the recovery journey and identifying areas for improvement. Methods PEEL is a prospective observational study exploring the events following discharge for emergency laparotomy patients in 3 NHS hospitals in Scotland, England and Wales. Inpatient and post-discharge data was collected from December 2017 to January 2019 and included: complications, new morbidities, re-presentation rates and re-admission rates. Results Over the 14-month period, 557 patients (51.7% female; mean age 61.2yrs ranging 16 – 93 yrs) were included in the PEEL study (Scotland n=199, Wales n=252 and England n=106). Overall, 12.3% of patients were discharged with an increased care requirement. In the Scottish cohort, 10.5% re-presented within 30 days of which all were re-admitted. In the English and Welsh cohort, 28.1% and 21.6% re-presented within 30 days resulting in 19.4% and 12.3% of patients being re-admitted respectively. Following discharge, 31.1% had a primary care referral made. Of this, 32.7% were to general surgery, 20.1% to gastroenterology and 13.2% to both mental health services and dieticians. Conclusions This study suggests that a significant proportion of patients seek support from primary or secondary care following discharge. An emergency laparotomy is likely to impact various aspects of a patient’s wellbeing and developing interventions to address these may help improve the recovery pathway.