503 Clinical Frailty Score (CFS) Vs Antibiotics, Time to Surgery and Time to Computerised Tomography (CT) Scan in An Emergency Surgical Population

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Abstract

Introduction Frail patients have increased mortality after surgery. However, it is not known if pre-operative process measures such as antibiotic administration, time to CT and time to surgery are influenced by patient frailty. Method The Emergency Laparotomy and Laparoscopy Scottish Audit (ELLSA) assessed outcome after emergency surgery across Scottish hospitals (November 2017 – October 2018). Frailty was measured using the 7-point Clinical Frailty Score (CFS). Outcome measures were antibiotic provision for sepsis, admission to CT time, admission to surgery time, CT request to performance time and CT request to surgery time. Results 1302 patients (median age 63 years [IQR 49-74]; 49% male) with complete data were included. Median time from admission to CT and surgery increased between those with CFS 1 to 6/7 from 597 to 1724 minutes (p < 0.0001) and 1556 to 4120 minutes (p < 0.0001) respectively. Time from CT request to surgery also significantly increased with CFS (p < 0.042). There was no significant association between CFS and antibiotic administration or CT request to performance. Conclusions Frail patients have to wait longer for CT scan requests and surgery, but frailty was not associated with antibiotic administration or delays in CT request to performance time. Possible explanations include frailty-related challenges making correct diagnoses and optimal management plans.
Original languageEnglish
Article numberznab134.193
Number of pages1
JournalBritish Journal of Surgery
Volume108
Issue numberSupplement_2
Early online date4 May 2021
DOIs
Publication statusPublished - 4 May 2021

Bibliographical note

Issue Section: EuroSurg Collaborative Prize

Keywords

  • antibiotics
  • sepsis
  • computed tomography
  • frailty
  • frail elderly
  • laparoscopy
  • laparotomy
  • surgical procedures
  • operative
  • mortality
  • surgery
  • specialty
  • outcome measures
  • process measures
  • emergency surgical procedures

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