EP 397 Does Critical Care Admission after Emergency Laparotomy Matter?

Aim Admission to critical care after emergency laparotomy is a quality measure on the NELA database for high risk (predicted mortality >5%) patients, though relatively little data exists on what benefits are conferred to patients with this level of care. This audit aimed to quantify the benefit that critical care admission gives to patients after surgery. Methods All patients who had emergency surgery with a NELA-predicted mortality risk of >5% at our district general hospital from 01.04.25 to 30.09.25 were identified from the NELA database. Incidence of post-operative morbidities (including development of Acute Kidney Injury [AKI], recorded hypotension, hospital acquired pneumonia (HAP), wound infection and ileus) were recorded and compared between patients who went to critical care against those that did not. Results 42 patients were identified, of which 28 (67%) were admitted to critical care after surgery. Patients who were admitted to critical care had lower rates of post-operative stage 2/3 AKI (25% vs. 42%), hypotension (14% vs. 33%) and post-operative ileus (25% vs. 58%). There were no significant differences in other post-operative complications (all AKI, HAP, wound infection). Conclusions Admission to critical care after emergency laparotomy conferred significant benefits, including reduced rates of more severe AKI, hypotension and ileus, though almost a third of patients could not access this resource. These findings support existing guidance advocating routine admission to critical care facilities after emergency surgery and hospitals should ensure this level of care is available for all patients.