FTP6.8 Impact of frailty on patients undergoing emergency surgeries under general anaesthesia in a district general hospital

Abstract

Abstract Aims To assess the impact of frailty on the outcome of elderly patients underwent emergency surgical procedures in a district general hospital. Methods All patients above 65 years who underwent moderate/ major risk emergency surgical procedures from 1st of January 2022 to 31st of Dec 2022 were included in retrospective study. Data was collected from on call hand over and hospital electronic patients record system. Their ASA (American society of anaesthesiologist physical status classification) and P-POSSUM (Portsmouth- Physiological and operative severity score for the enumeration of mortality and morbidity) was calculated. Results Eighty-five patients (males:47, females:38) underwent emergency procedures in one year period. Age range was 65 to 90 years with mean age was 80.6 years. We performed 57 laparotomies, seven had laparoscopic bowel surgery. Other procedures were incarcerated hernias repair, appendectomies, lap/ open cholecystectomy/ cholecystostomy, debridement of necrotising fasciitis. Twenty-eight patients were frail (CFS 5-7) with mean ASA 3.4 and mean P-POSSUM mortality was 14.89. Fifty-seven patients were non frail with mean ASA 2.59 and P-POSSUM mortality was 16.12. Length of hospital stay was from 1 to 106 days, average being 13.7 days. Average length of stay for frail patients was 15.8 days and for non-frail was 12.9 days. Twelve patients died within 30 days of surgery or during the same admission, among them 54% were frail. Seventy five percent of mortalities were after bowel surgeries, mainly after stoma formation (both open and laparoscopic approach). Conclusions Clinical frailty scale is one of the predictors of prognosis along with other parameters and must be calculated at the time of admission.