422 Does Surgeon Age Influence the Outcome of Emergency Laparotomies? a Single Centre Retrospective Study

Aim In the United Kingdom, over 20000 emergency laparotomies are performed annually and reported in the National Emergency Laparotomy Audit (NELA). Although the mortality rate after emergency laparotomy has fallen recently, it is still significantly higher than elective surgery. Many studies have assessed the correlation between patient factors and institutional provisions against emergency laparotomy outcomes. However, there is limited evidence for the influence of surgeon related factors. To assess the influence of surgeon age on mortality rate for patients undergoing emergency laparotomy. Method Data was collected from NELA (2014–2018). Operations performed by surgeons who were locums, non-consultants or from a speciality outside of general, vascular or transplant surgery, and those with missing data were excluded. Surgeon age <50 or >50 years were compared to 30-day, 60-day, 90-day and 1-year mortality. Results In total, 1147 patients were included and 264 (19%) excluded for the reasons listed above. There was no significant difference in the mean 30-day, 60-day, 90-day and 1-year mortality between the groups. The mean mortality rates for <50 years (>50 years) were 11.60% (11.80%), 14.70% (14.60%), 15.00% (14.80%) and 15.20% (15.00%) respectively (p=0.44). Surgeons aged >50 years had a 10% decrease in overall mortality rate compared to 4% for the <50 group. There was a significant difference in patient demographics between the two groups as the >50 group had a higher risk caseload (p=0.02). Conclusions Overall mortality after emergency laparotomy was not related to surgeon age but older surgeons undertook higher risk cases.