Changes in frailty status and discharge destination post emergency laparotomy

Area of Science:

• Gerontology
• Surgical Outcomes
• Public Health

Background:

• Pre-operative frailty negatively impacts outcomes after emergency laparotomy (EmLap), particularly in adults aged 65 and older.
• Limited understanding exists regarding frailty changes post-EmLap and their effect on patient disposition.

Purpose of the Study:

• To investigate the change in frailty status from pre-operative to 90-day post-operative assessment in EmLap patients.
• To determine the influence of frailty status changes on discharge destination after EmLap.

Main Methods:

• Prospective study of 63 EmLap patients aged 65 years and above.
• Frailty assessed using the Rockwood Clinical Frailty Scale pre-EmLap and at 90 days post-EmLap.
• Analysis of demographics, mortality, and discharge destination, with significance set at p < 0.05.

Main Results:

• 17.5% of patients were frail pre-EmLap; 15.9% developed new frailty by 90 days post-EmLap.
• 25.8% of patients experienced a change in discharge destination, with a significant association between pre-EmLap frailty and altered home circumstances (p < 0.00001).
• Of those with a changed discharge destination, 56.3% were frail pre-EmLap.

Conclusions:

• Emergency surgery can exacerbate frailty, increasing post-discharge care needs.
• Pre- and post-operative frailty assessments are essential for improving care planning and managing patient expectations after EmLap.