WP7.11 - An Audit of Geriatric Input and Analysis of The Barriers For Elderly Patients Undergoing Emergency Laparotomy

Abstract

Abstract Background Older people over the age of 65 years are recognized as higher risk surgical candidates and it is therefore recommended that their care should be coordinated through a multidisciplinary team (MDT) approach involving senior geriatricians, anaesthetists and surgeons. We audited 150 geriatric patients for medical input. Further in addition to the liaison services we analysed the characteristics of this group that would have benefitted from a liaison service. Methods An audit of 150 geriatric patients undergoing emergency laparotomy was carried. Our primary outcome was to look at input from geriatricians following laparotomy. Further we assessed the clinical characteristics of these patients and analysed the complexity of medical needs to benefit from a physician input. Results Only around 10% patients received a medical/geriatric input following an emergency laparotomy. Our audit highlighted the gap that exists in the clinical care for geriatric population against the NELA recommendations. Further we were able to work out a model of implementation for a geriatric liaison service. Conclusions Management of older patients with complexity requires surgical, critical care and geriatricians to collaborate. Implementing a local service with regular MDT’s will only serve to improve care and outcomes.