Mohamed Youssef
Background
Frailty is a syndrome of decreased physiological and cognitive reserve across systems characterised by increased vulnerability to physiological insult. Patients who are elderly and frail at greater risk of complications and poor outcomes.
Aim
The primary aim of this study was to assess the rates of referral and review of elderly patients admitted in surgical wards by geriatrician team.
Methods
This was a retrospective study conducted over a three-month period between October and December 2024, at the Royal Wolverhampton NHS Trust, and included patients aged 65 years and older admitted under general surgery in emergency setting.
Results
This study included 65 patients, with a median age of 77, with 61.5% as females. According to Rockwood frailty score, patients were categorised into mildly frail, moderately frail, severely frail and very severely frail, 9 patients (14%), 6 patients (11%), 5 patients (8%), 4 patients (6%), respectively. Patients were then divided into two groups based on the modality of management: laparotomy group and nonoperative group. The results showed a significant improvement in COE referral rates by the surgical team, with referrals increasing from 10% to 71.5% in the laparotomy group and from 21% to 60% in the non-operative management (NOM) group.
Conclusion
Introduction of a joint service between geriatric medicine and general surgery departments is the key to an effective service provided to elderly, frail patients. Lack of fund in some trusts and the absence of unified policy across the NHS are the key obstacles to providing a liaison between both specialities.
Authors
Mohamed Abuahmed
Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
Spencer Mok
Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
Hashim Abdullah
Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom
Wadah Abdelazim
Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom