TTP7.12 Bowel Obstruction in the Octogenarian: Our 10-year NELA data analysis

Aims The aim of this extensive study is to describe the distinctive characteristic of the patient population that is aged 80 or over in relation to their emergency presentations requiring a laparotomy. Methods We collected NELA data spanning over 10 years at our hospital. We filtered patients that were aged 80 years or older, who as a result of their age were at a baseline higher risk during the peri-operative period. 235 patients fell into this category, consisting of 47.66% of females and 52.34% males. The co-morbidities of these patients were taken into account to objectively establish their pre-operative baseline functional status by calculating the ASA grade and Clinical Frailty Score. This data was compared against the type of surgery they underwent followed by their post-op journey. Results 50% of the over 80-year-olds who have laparotomies tend to have it secondary to bowel obstruction. 47.63% of patients who underwent an emergency laparotomy were ASA grade 3 and most patients had frailty scores of 4 or above. The median NELA score was 10% or above. The majority of these patients spent 1-3 days in ITU post-operatively. Conclusions Octogenarians were higher risk but had different presenting pathology compared to younger patients. They had a prolonged initial conservative management period during which time they were optimized. Due to their pre-morbid state as established by the NELA scores, they had less extensive surgery. Most of these patients went to ITU, HDU or Level 1 areas post-operatively. Hence, careful patient selection for laparotomies is key.