TPTh 4.16 Does Geriatric Involvement Protect Frail Patients Undergoing Emergency Laparotomy? An Exploratory Observational Study

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ID: 323871
2026
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Abstract
Abstract Aims The National Emergency Laparotomy Audit (NELA) recommends a Peri-operative Care of Older People undergoing Surgery (POPS) review for patients undergoing emergency laparotomy aged ≥80 years (≥65 years if frail). We aimed to investigate patient characteristics, POPS review and outcomes between two acute hospitals within an NHS Trust, one with peri-operative geriatrics services and one without. Methods A retrospective observational study investigated patients aged ≥65 years undergoing emergency laparotomy over 6 months at a large NHS Trust. Age, Clinical Frailty Scale (CFS), co-morbidities, indication for surgery, length of stay (LOS), mortality and documentation of peri-operative decision-making were analysed. Results There were 90 patients with median age 78 (IQR 71–83) years (n=50 POPS site and n=40 non-POPS site). Bowel obstruction was the most common indication. POPS reviews were recorded for 64% (32/50) at the POPS site and 0/40 at the non-POPS site; p<0.001. Median LOS was higher at the POPS site (25 (IQR 12–40) vs. 11 (7–20) days; p<0.001), and a higher proportion required admission to the Intensive Care Unit (38/50 vs. 13/40 respectively; p<0.001). In-hospital mortality was 24% (12/50) vs. 30% (12/40) respectively; p=0.633). Documentation regarding operative decision-making was more complete at the POPS site, with earlier involvement of pre-operative optimisation. Conclusions There were comparable mortality outcomes between sites despite a more unwell POPS cohort, who were more often reviewed in the perioperative period by POPS. These data generate the hypothesis that peri-operative geriatrics involvement (as recommended by NELA) support safer emergency laparotomy care.
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Authors Tanya Bhalla, Kamila Rakhimova, Clare Hughes, David N. Naumann, Nicholas Newton
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.468
URL
https://doi.org/10.1093/bjs/znag087.468
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