EP.TU.156Frailty in the Emergency General Surgical Cohort, could we being doing more?

Abstract

Abstract Aims Frailty, a state of diminished diminished physiological capacity to deal with external stimuli, is being seen ever increasingly in the aging emergency general surgical cohort. Length of hospital stay, morbidity and mortality are shown in the literature to dramatically increase in the frail population. Outcomes in this cohort are shown to improve significantly with specialist frailty input from geriatricians, physiotherapy and occupational therapy teams. The authors aimed to assess the burden of frailty in emergency surgical admissions in a District General Hospital, and the frailty specialist care these patients received. Methods A snapshot survey of all acute surgical admissions during a single 24 hour period was performed. Frailty was defined as a Rockwood Clinical Frailty Scale score of 5 or above. The management of these patients was then compared to national standards and recommendations made on how the treatment of the clinically frail could be improved upon. Results 73% of patients in the sampled cohort (19/26) were found to be clinically frail. Only 2 (10%) of these patients had been reviewed by the frailty specialist teams within the hospital. Following implementation of recommendations, namely an improved referral system, reminders within initial clerking paperwork and raising departmental awareness, specialist input was shown to increase threefold to 32% (10/31) within the same patient group. Conclusions A significant cohort of emergency general surgical patients are classified as clinically frail. Optimal care for these patients involves a multidisciplinary approach, the uptake of which can be increased significantly with intra-departmental education and increased awareness.