eP92 Impact of a ‘Peri-operative Care of Older People undergoing Surgery (POPS)’ service on length of hospital stay in older patients undergoing emergency laparotomy
Timothy Beach, Anna Tennant, Marianne HollymanAbstract
Aims
Older and frailer patients undergoing emergency laparotomy face increased morbidity, mortality, and length of hospital stay (LOS). Multidisciplinary teams, such as POPS (Peri-operative Care of Older People undergoing Surgery), aim to address these issues. We assessed the impact of our POPS team on LOS in older patients undergoing emergency laparotomy.
Methods
We conducted a retrospective analysis comparing LOS in patients aged 65 and above from the NELA database who met NELA criteria for geriatric review before (2014–2017) and after (2019–2020) the introduction of the POPS service at our hospital.
Results
In patients aged 65 and over undergoing emergency laparotomy between 2019 and 2022 (n=396), clinical frailty score significantly increased with age (P < 0.001), and higher frailty scores were associated with increased LOS (P = 0.047). NELA criteria mandate perioperative geriatric review for all patients aged 80 and above, regardless of frailty. Given the lack of frailty data before 2019, we compared LOS in patients aged 80 and over before (n=137) and after (n=111) the introduction of the POPS service. Eighty-eight percent of patients aged 80 and over were reviewed by the POPS team between 2019 and 2022, and LOS decreased from 19 to 16 days (P = 0.17), equating to over 300 ‘bed days’ saved.
Conclusion
The introduction of the POPS team has reduced LOS for older emergency laparotomy patients. Future assessment of additional measures, including discharge destination or time to mobilisation, may further demonstrate the team's positive impact on patient care.