P461: Cognitive impairment in consecutive emergency admissions to an acute surgical unit: implications for capacity and consent

Abstract

our experience in the surgical management of the elderly with colorectal cancers. Methods: Patients over 65 years undergoing elective or emergency colorectal surgery were enrolled prospectively from January 2010 to December 2013. Preoperative CGA was performed and the patients were categorized as fit or frail. Postoperative complications within 30 days of surgery and hospital stay were measured. Results: In this study were included 106 patients (61 males and 45 females). Emergency surgery was performed in 27 patients. 84.9% were identified preoperatively as frail. Overall mortality rate was 15% (15/16 deaths from the frail group). The overall postoperative complication rate was 40.6% with the majority categorized as class I and II complications. The complication rate was 42% for both groups and no statistical significance was found (p =0.45) but 6.86% were identified as severe class IV and V complications only in the frail group. Postoperatively, 67% of the patients were hospitalized for 15 days. Conclusions: Surgery for elderly patients with colorectal cancer is associated with significant morbidity and mortality rates. Preoperative application of CGA to risk stratify the surgical patients undergoing colorectal surgery is able to reveal that severe complications and deaths is more likely to happen in the frailty group. Further patient selection, preoperative optimization and informed decisions by the physicians have the potential to improve the care of older patients undergoing colorectal surgery.