1018 Emergency General Surgery; Physiology and Frailty Assessment with Surgical Outcome Analysis, in a Single-Centre Retrospective Cohort Study

Abstract

Introduction Emergency General Surgery (EGS) deals with the most critical of patients. It is a field that requires the precise and timely execution of life-saving interventions. For this reason, many studies have been conducted in order to find the optimal management plans. Our research compared different scoring systems, to see which performed best in regard to Geriatric patients. Scoring systems included: APACHE II, ASA, ACS-NSQIP, MPI, and Frailty Score. The Clavien Dindo classification was utilised as a comparative tool. Our secondary objective was to determine which variables had the greatest effect on patient outcomes. These variables included Age, Sex, BMI, Time to Surgery, Beta-blockers, ‘Open Abdomen’ treatment, Blood Transfusions, Anticoagulants, and Vasopressors. Method The database included 212 patients who underwent EGS in a consecutive 24-month period. Results All of the scoring systems proved to be statistically significant with the ACS and the ASA being most effective for predicting death and short-term complications. Regarding variables, we performed both univariate and multivariate testing. For predicting the risk of death, ‘Open Abdomen treatment’, Blood Transfusions, and Vasopressors were statistically significant. For estimating the risk of short-term complications only Blood Transfusions and Vasopressors proved significant Conclusions We must take into consideration that the other systems had significant results, therefore we must contemplate if there were compounding factors. To rectify this, further studies should be conducted ensuring correct parameters are respected, for example, the APACHE II should only be used in ICU patients and within the first 24 hours of admission.