EP.FRI.948 Outcomes Following Emergency Laparotomy In The Over 70’s

Aim Surgery in the elderly carries greater risk of mortality with those who are frail being most at risk. We aimed to review our outcomes for patients 70 years of age and over, who underwent emergency laparotomy. Methods All patients aged 70 and over who had undergone emergency laparotomy within a 12-month period were included for analysis. Patient’s pre-operative risk was assessed by the P-Possum and NELA scoring along with Rockwood Frailty Scale (RFS) and the Geriatric rescue after surgery (GRAS) score.  Results 50/116 patients undergoing emergency laparotomy were aged over 70 years old. Full data was available for 47 of these. Overall 30- and 90-day mortality was 12.8% and 21.3% respectively. 90-day mortality in patients with a RFS of > 4 was 25% compared with 16% with a score of 4 or less. Those with a GRAS score <4 and 4 or greater had a 90-day mortality of 16% and 27% respectively. Where there was a P-Possom mortality risk >10% was no difference in the mortality rates, however when the NELA risk was >10%, 90 day mortality was 26.6% compared with 15.4%.  Conclusion Emergency laparotomy in the over 70’s carries much higher risk of death. Mortality risk scoring and frailty assessments are useful tools in counselling patients and their families prior to surgery. Future work will assess the predictive value of different and combined scores in this population.