Changes in frailty status and discharge destination post emergency laparotomy
Abstract Background Pre-operative frailty adversely affects morbidity and mortality after emergency laparotomy (EmLap), especially in older adults (65 years and above). Little is known about frailty after EmLap. We explored the change in frailty status from pre- to post-EmLap and any influence on di...
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| Language: | English |
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BMC
2025-04-01
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| Series: | World Journal of Emergency Surgery |
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| Online Access: | https://doi.org/10.1186/s13017-025-00612-8 |
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| author | Hwei Jene Ng Nicholas J. W. Rattray Tara Quasim Susan J. Moug |
| author_facet | Hwei Jene Ng Nicholas J. W. Rattray Tara Quasim Susan J. Moug |
| author_sort | Hwei Jene Ng |
| collection | DOAJ |
| description | Abstract Background Pre-operative frailty adversely affects morbidity and mortality after emergency laparotomy (EmLap), especially in older adults (65 years and above). Little is known about frailty after EmLap. We explored the change in frailty status from pre- to post-EmLap and any influence on discharge destination. Methods EmLap patients aged ≥ 65years from an acute surgical site were recruited from May 2022 to April 2023. Prospective data collection included demographics, frailty, mortality and discharge destination. Frailty was assessed using the Rockwood Clinical Frailty Scale at pre-EmLap and day-90 post-EmLap (< 4 as non-frail, 4 as pre-frail and > 4 as frail). EmLap patients with no 90-day follow-up were excluded. A p-value of < 0.05 was considered significant. Results 63 EmLap patients were included in the study. The median age was 75 years (range 65–91 years) with 36 (57.1%) females. Eleven (17.5%) were living with frailty pre-EmLap, and 10 (15.9%) developed new frailty by day-90 post-EmLap. Pre-EmLap, all patients came from home with 20.6% of the frail and pre-frail group having a package of care service (POC) in place. On 90-day post-EmLap, 1 was still an inpatient but 25.8% had a change in discharge destination: care home (n = 1), home with new POC (n = 2) and home with increased POC (n = 13). Of the 16 patients with change of discharge destination, 9 (56.3%) were frail pre-EmLap. There was a significant association between pre-EmLap frailty and change in home circumstances on discharge (p < 0.00001). Conclusions Emergency surgery can increase a patient’s frailty status and significantly increases care requirements and social support after hospital discharge. Frailty assessment needs to be performed before and after admission in all EmLap patients to improve post-EmLap care planning and patient expectations. |
| format | Article |
| id | doaj-art-370a8f8f79b34dcfbb0c36dedfbfabb4 |
| institution | OA Journals |
| issn | 1749-7922 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj-art-370a8f8f79b34dcfbb0c36dedfbfabb42025-08-20T02:30:22ZengBMCWorld Journal of Emergency Surgery1749-79222025-04-012011610.1186/s13017-025-00612-8Changes in frailty status and discharge destination post emergency laparotomyHwei Jene Ng0Nicholas J. W. Rattray1Tara Quasim2Susan J. Moug3Department of General Surgery, Royal Alexandra Hospital, NHS Greater Glasgow and ClydeStrathclyde Institute of Pharmacy and Biomedical Sciences, University of StrathclydeCollege of Medical, Veterinary and Life Sciences, University of GlasgowDepartment of General Surgery, Royal Alexandra Hospital, NHS Greater Glasgow and ClydeAbstract Background Pre-operative frailty adversely affects morbidity and mortality after emergency laparotomy (EmLap), especially in older adults (65 years and above). Little is known about frailty after EmLap. We explored the change in frailty status from pre- to post-EmLap and any influence on discharge destination. Methods EmLap patients aged ≥ 65years from an acute surgical site were recruited from May 2022 to April 2023. Prospective data collection included demographics, frailty, mortality and discharge destination. Frailty was assessed using the Rockwood Clinical Frailty Scale at pre-EmLap and day-90 post-EmLap (< 4 as non-frail, 4 as pre-frail and > 4 as frail). EmLap patients with no 90-day follow-up were excluded. A p-value of < 0.05 was considered significant. Results 63 EmLap patients were included in the study. The median age was 75 years (range 65–91 years) with 36 (57.1%) females. Eleven (17.5%) were living with frailty pre-EmLap, and 10 (15.9%) developed new frailty by day-90 post-EmLap. Pre-EmLap, all patients came from home with 20.6% of the frail and pre-frail group having a package of care service (POC) in place. On 90-day post-EmLap, 1 was still an inpatient but 25.8% had a change in discharge destination: care home (n = 1), home with new POC (n = 2) and home with increased POC (n = 13). Of the 16 patients with change of discharge destination, 9 (56.3%) were frail pre-EmLap. There was a significant association between pre-EmLap frailty and change in home circumstances on discharge (p < 0.00001). Conclusions Emergency surgery can increase a patient’s frailty status and significantly increases care requirements and social support after hospital discharge. Frailty assessment needs to be performed before and after admission in all EmLap patients to improve post-EmLap care planning and patient expectations.https://doi.org/10.1186/s13017-025-00612-8Emergency laparotomyFrailtyDischarge destination |
| spellingShingle | Hwei Jene Ng Nicholas J. W. Rattray Tara Quasim Susan J. Moug Changes in frailty status and discharge destination post emergency laparotomy World Journal of Emergency Surgery Emergency laparotomy Frailty Discharge destination |
| title | Changes in frailty status and discharge destination post emergency laparotomy |
| title_full | Changes in frailty status and discharge destination post emergency laparotomy |
| title_fullStr | Changes in frailty status and discharge destination post emergency laparotomy |
| title_full_unstemmed | Changes in frailty status and discharge destination post emergency laparotomy |
| title_short | Changes in frailty status and discharge destination post emergency laparotomy |
| title_sort | changes in frailty status and discharge destination post emergency laparotomy |
| topic | Emergency laparotomy Frailty Discharge destination |
| url | https://doi.org/10.1186/s13017-025-00612-8 |
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