AB097. SOH25_AB_390. A multi-centre prospective snapshot audit of frailty amongst emergency general surgery admissions

Background: As the population ages, older patients with complex comorbidities are increasingly being admitted to hospitals with surgical pathology. Independent of age and comorbidities, frailty predicts mortality, complications, prolonged length of stay and loss of independence after hospitalisation. Understanding of the impact of frailty on unscheduled surgical care is needed to guide future service provision. This prospective collaborative study aimed to determine the prevalence of frailty amongst emergency general surgery admissions.

Methods: A multi-centre prospective snapshot audit was performed over a two-month period in four Irish hospitals. For fourteen consecutive days, all emergency general surgery admissions >60 years was screened for frailty using the Clinical Frailty Score (CFS) by the on-call team. Details on demographics, comorbidities and lab data were recorded from the “Surgical Sign-Out” documents. Discharge summaries were subsequently reviewed, and 30-day outcomes documented.

Results: Across the four sites, 396 admissions were recorded. Forty percent (n=160) of the total cohort were >60 years. Frailty scores were available for 128 patients >60 years, of which 60% were pre-frail or frail. Further patient-level data was available for 80 patients >60 years. Frail patients required significantly more multi-disciplinary team input (69% vs. 7%, P=0.050) and had proportionally higher rates of anaemia (50% vs. 28%), polypharmacy (48% vs. 25%), medical consults (48.5% vs. 44.4%) and inpatient mortality (9.5% vs. 0%).

Conclusions: Though the data is preliminary, high levels of frailty were noted amongst emergency surgical admissions. Routine frailty screening and proactive specialist geriatric input may lead to improved outcomes in this high-risk cohort.

Keywords: Emergency general surgery; frailty; audit; surgical outcomes; surgical geriatrics