Abstract Aims To quantify how many elderly patients had frailty assessment before emergency surgery and assess association of frailty with post-operative complications. Methods Patients over 65 who had any emergency operation in our District General Hospital from January 2024 to December 2024 were identified. Clinical, operative and post-operative details were recorded from individual Electronic Patient Records. Patients who did not have surgery, or who had procedures on orthopaedic 'trauma' lists were excluded. Results 340 elderly patients had emergency surgery (250 General Surgery, 78 Urology, 12 Orthopaedics). Median age was 76 years (range, 65 – 99). 236 patients were aged between 65-79, and 104 patients 80. 13 patients in the 65-79 group (6%) and 33 patients in the 80 age group (32%) had pre-operative comprehensive geriatric assessment (CGA) performed by Frailty Specialist teams (FST) which produced a Rockwood clinical frailty score (CFS). The mean CFS for the 65-79 and 80 age groups was 3.23 and 3.73 respectively. 99 patients (29%) had post-operative complications. 23 patients (7%) developed delirium and other frailty-related complications. Of these, 8 patients (35%) were assessed pre-operatively by FST with a mean CFS of 4.63. 12 patients (4%) died in the index admission. Of these, only 3 patients (25%) were assessed pre-operatively by FST with a mean CFS of 5. Conclusion Post-operative complications and mortality are associated with emergency surgical patients with higher clinical frailty scores. Strategies to improve pre-operative frailty detection in the emergency setting is important to anticipate complications and tailor management.
Yau et al. (Fri,) studied this question.
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