SP1.5 Mortality rate for frail and sarcopenic patients post emergency laparotomy

Abstract

Abstract Aims Frail patients and sarcopenic patients are predicted to have high morbidity and mortality after undergoing emergency laparotomy (EmLap). However frailty and sarcopenia can be present independently or mutually. We aim to explore the association between 30- day mortality, frailty and sarcopenia. Methods Analysis was performed on a prospectively collected database of EmLap patients ≥40 years in a busy district hospital. Frailty was assessed via Clinical Frailty Score with score ≥4 defined as frail. Sarcopenia was assessed via total psoas index (TPI). TPI is the total L3 psoas area on CT (cm2)/ patient’s height (m2), stratified according to gender with sarcopenia being present in the lowest quartile. Statistical analysis was performed using logistic regression and p value of <0.05 was considered significant. Results 100 patients were included with a median age of 66 years; 59% were female. The overall 30- day mortality rate was 9%. Frailty was present in 49% and within this group, mortality rate was 16.3% (OR 9.76, p= 0.012), 24% were sarcopenic and 30- day mortality was 12.5% (OR 1.57, p= 0.545). 14% of patients were both frail and sarcopenic and the 30- day mortality was 21.4% (OR 3.64, p= 0.080). Conclusion Mortality rate is high in EmLap patients and is higher when patients are both frail and sarcopenic. Frailty and sarcopenia are interlinked and can be improved, hence both should be assessed in all EmLap patients to allow early identification, improvement in shared decision making and development of targeted post-operative interventions to improve EmLap outcomes in this cohort of patients.