Authors:
- Dr Ee-Neng Loh, Anaesthetic NELA fellow
- Ms Lyndsay Pearce, NELA Surgical/ Research Lead
- Dr Sarah Hare, Deputy Director RCoA Centre for Research and Improvement
The challenges of providing care for an aging surgical population require no further introduction. Perioperative clinical teams are often managing surgical patients with multiple complex co-morbidities, higher levels of frailty, and poorer physiological reserve.
In the eighth annual report of the National Emergency Laparotomy Audit (NELA), we found that more than half of the patients undergoing emergency laparotomy (EL) were 65 years old or more, and that around 20% were aged over 80 years.1 Despite improvements in perioperative care, one in ten patients die within 30 days of their surgery and mortality risk doubles in patients living with frailty.1,2 Are we doing more harm than good by subjecting these patients to surgery?