FP7.5 - 90- day mortality rate post emergency laparotomy for frail and sarcopenic patients

Abstract

Abstract Aims High mortality and morbidity rate post emergency laparotomy (EmLap) has been well documented in frail or sarcopenic patients. Although frailty and sarcopenia can be present concurrently, they can also occur independently. We aim to explore the relationship between 90- day mortality, frailty and sarcopenia. Methods Prospectively collected data from EmLap patients age ≥40 years between May 2022 to July 2023 including 3 months follow-up from a district hospital was analysed. Clinical Frailty Scale was used to assess frailty with score >4 as frail. Total psoas index (TPI) [TPI=total L3 psoas area on CT (cm2)/ patient’s height (m2)] was measured on pre-operative CT to assess sarcopenia, stratified according to gender with lowest quartile as sarcopenic. Logistic regression was performed and p-value of <0.05 was considered significant. Results 150 patients were recruited, 55% were female and median age was 69 years. The overall 90- day mortality rate was 13.3%. Frailty was present in 10% and 90-day mortality rate was 13.0% (OR 1.00, p= 1.000) while 23.6% were sarcopenic and 90- day mortality rate was 25.7% (OR 3.21, p= 0.0197). 4% were both frail and sarcopenic with 90- day mortality rate of 33.3% (OR 3.50, p= 0.1648). Conclusion The 90-day mortality rate is higher when frailty and sarcopenia are both present in EmLap patients. Early evaluation of frailty and/ or sarcopenia in emergency setting is crucial to improve EmLap outcomes and aid shared decision making.