Annual research led by the Royal College of Anaesthetists (RCoA) focusing on the care of over 24,800 NHS patients before, during and after emergency bowel surgery has shown that enhanced patient care has successfully reduced the 30-day mortality rate from 11.8 per cent in 2013 to 9.3 per cent in 2019. But problems with other elements of patient care still remain, the College says.
The 2020 National Emergency Laparotomy Audit report has shown that while there have been improvements in key areas of patient care, these are masking significant concerns, especially in the care for elderly patients.
Despite the fact that people aged over 65 years now represent approximately 56 per cent of all emergency colon surgeries, only 28.8 per cent of those in the frail category received care from a geriatrician, a significant reduction from 36.9 per cent in 2018. Only 30 per cent of patients aged 80 years were assessed by a geriatrician
It is recommended that all clinicians treating patients over the age of 65 years must formally assess and document frailty. Frailty scoring must be considered an integral part of a formal risk assessment. However, the lack of consistent geriatrician input for elderly patients shows this is not happening across many hospitals, the RCoA says.
The College says the findings support calls for geriatricians to be embedded with anaesthetists, surgeons and other specialties within general surgery.
