SP 9.05 The Impact of Geriatrics Input on 30-Day Mortality Rates After Emergency Laparotomy in Older Adults in Scotland (ELLSA 2024 Data)
Ellen Groundwater, Susan MougAbstract
Introduction
Frailty is a key determinant of outcomes following emergency laparotomy but recognition and management remains inconsistent across Scotland. Older adults make up a substantial proportion of the emergency general surgery population and experience higher mortality. Using data from the Emergency Laparotomy in Scotland Audit (ELLSA) 2024, we examined the prevalence of frailty in patients aged 65 years and over and explored associations between geriatric input and 30-day postoperative mortality.
Results
In 2024, ELLSA recorded 1,522 emergency laparotomy procedures, with 50.1% of patients aged 65 years and over. 94 patients aged 65 and over were classified as living with frailty (Clinical Frailty Score of 5 or more). Older patients were stratified by frailty status and whether they had received geriatrics input. 30-day mortality rates were compared between groups. Among non-frail older patients, mortality was lower in those who received geriatric review compared with those who did not (9.0% versus 12.0%). In frail older patients, the difference was greater, with mortality of 17.0% in those reviewed by geriatrics compared with 24.5% in those without specialist input.
Conclusion
These findings are in keeping with national data from the 10th annual National Emergency Laparotomy Audit (NELA) report. As seen in NELA, frailty was associated with higher mortality and outcomes appeared better among patients who received geriatric input. The consistency between Scottish ELLSA data and national NELA findings supports the external validity of these results and highlights frailty identification and access to geriatrics input as key opportunities for service improvement in emergency laparotomy care.