SRS247 - Are we managing anaemia in patients undergoing emergency laparotomy?

Aim/Objectives There has been a drive on improving outcomes after Emergency Laparotomy (EmLap) due to National Emergency Laparotomy Audit (NELA). This has focused mainly on preoperative and intraoperative management with less emphasis on other perioperative aspects. We aimed to assess the prevalence of anaemia in EmLap patients and its management in peri-operative period, exploring the gaps in anaemia care. Methods A retrospective study of prospectively maintained database of 1055 EmLap patients (2016–2019) from a UK tertiary centre was performed. Data extracted from the NELA database, PEEL-2 study, electronic records (Welsh Clinical Portal). Statistics were performed in SPSS v27. Results Among 740 patients, 77% underwent open surgery, with mean age of 61.9 years (range 18–98), median age of 65 years, roughly equal sex distribution (female 54%). The median pre-operative NELA risk was 3.6% (IQR 1.1–9.8). Over a quarter of patients (27.1%) were anaemic on admission. Anaemic patients had significantly longer hospital stays (median 12 days; >/ = 11 days, P = 0.008), higher stoma formation rates (54.1% moderate anaemia versus 34.3% non-anaemic; P = 0.002). Three-quarters of patients (74.2%) were anaemic at discharge (median Hb: 108 g/L, range: 54–129 g/L) but only 12% were treated with oral or IV iron or both, only 10% had anaemia reported in their discharge letters with appropriate follow-up and management plan. Conclusions Anaemia in patients undergoing emergency laparotomy is significantly under-recognised and inadequately managed at discharge, despite recognised increased morbidity. A structured pathway for continuing anaemia treatment, and discharge planning is urgently needed to improve outcomes.