WP7.2 - The Role of a Frailty Team to improve Perioperative Care for ELLSA Patients

Abstract

Abstract Aim Frailty assessment amongst emergency laparotomy patients is essential. The 8th NELA report highlighted that only 31.8% of patients who were frail and over 65 years received geriatrician input. Within our organisation, patients who undergo emergency laparotomy are included in the Emergency Laparotomy and Laparoscopic Scottish Audit (ELLSA). The consultant geriatrician led Surgical Acute Frailty Team (SAFT) works collaboratively with the emergency general surgery team and ELLSA specialist nurse to review ELLSA patients within our hospital. Our aim was to establish outcomes of ELLSA patients reviewed by SAFT. Methods Data collected routinely via Redcap as part of our organisation’s ELLSA was reviewed. All ELLSA patients aged ≥65 years admitted between November 2022 and November 2023 were included. Data included frailty assessment, discharge destination and 30 day mortality. Results 152 patients aged ≥ 65 years underwent operative intervention as defined by ELLSA. 100% of patients had a documented Clinical Frailty Scale (CFS) score. 72 patients (47.4%) had a pre-operative frailty review. 68.4% of patients had their initial frailty assessment by a consultant geriatrician. 19.7% of patients were reviewed by frailty ANPs or clinical fellow. Only 7.9% of patients required care support on discharge. 30 day mortality was 17.1%. Conclusions Embedding a dedicated frailty team within our general surgery wards has been incredibly successful; frailty assessment is significantly above that of the 8th NELA report. The majority of ELLSA patients aged ≥65 years are discharged home independently. Collaborative working and early identification of frailty in ELLSA patients is essential to improve patient outcomes.