EP 466 Communicating the Mortality Risk to our Emergency Laparotomy Patients and their Next of Kin

Aims

To identify our communication of mortality risk to patients undergoing emergency laparotomy and their NOK, and recognise influencing factors.

Methods

A retrospective analysis of emergency laparotomies carried out over a 3-month period in our district general hospital. 24 Laparotomies were included. Clinical notes on the electronic health record were reviewed to see if mortality risk discussion between the medical team, patient, and NOK, had been documented.

Results

Risk of mortality was recorded as being discussed with 5 patients (20.8%) and 6 family members (25%). It was discussed with either the patient or the family in 9 cases (37.5%) therefore neither in 62.5%. Factors that affected mortality discussion included patient age and their ASA.

The median age of the 9 patients who had mortality discussed with either themselves or family was 69, and their median/mode ASA was 4.

The median age of patients who did not have mortality discussed was 62, and their median/mode ASA was 3.

4 of the 24 patients did not have capacity and required a consent form 4; all of these patients had risk discussed with NOK

It did not make a difference whether the patient was operated on during the day or night.

Consultants and registrars were equally likely to discuss mortality risk.

Conclusions

We are not adequately discussing the risk of mortality to our patients and their NOK.

We are more likely to discuss mortality when the patient is older and with more co-morbidities, as evidenced by increased ASA score.