FRAILTY USING THE CLINICAL FRAILTY SCALE TO PREDICT SHORTAND LONG-TERM ADVERSE OUTCOMES FOLLOWING EMERGENCY LAPAROTOMY: META-ANALYSIS brittany.park09@gmail.com

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FRAILTY USING THE CLINICAL FRAILTY SCALE TO PREDICT SHORTAND LONG-TERM ADVERSE OUTCOMES FOLLOWING EMERGENCY LAPAROTOMY: META-ANALYSIS

7

New Zealand

Oral or Poster

Emergency laparotomy has high morbidity and mortality rates. Frailty assessment remains underutilized in this setting, in part due to time constraints and feasibility. The Clinical Frailty Scale is the most appropriate tool for frailty assessment in emergency laparotomy patients and is recommended for all older patients undergoing emergency laparotomy. The prognostic impact of measured frailty using the Clinical Frailty Scale on short- and long-term mortality and morbidity remains to be determined.

Observational cohort studies were identified by systematically searching Medline, Embase, Scopus and CENTRAL databases up to February 2024, comparing outcomes following emergency laparotomy for frail and non-frail participants defined using the Clinical Frailty Scale. Primary outcomes were short- and long-term mortality. A random-effects model pooled effect estimates, and a separate narrative synthesis was created. Risk of bias was assessed.

Twelve articles comprising 5704 patients were included. Frailty prevalence was 25% in all patients and 32% in older adults (age ≥55 years). Older patients with frailty had a significantly greater risk of postoperative death (30-day mortality OR 3.84, 95% c.i. 2.90 to 5.09; 1-year mortality OR 3.03, 95% c.i. 2.17 to 4.23). Meta-regression showed variations in frailty cut-offs did not significantly affect the association with 30-day mortality. Frailty was associated with higher major complication rates (OR 1.93, 95% c.i. 1.27 to 2.93) and discharge to increased care.

Frailty is significantly associated with mortality, morbidity, and adverse functional outcomes. Identifying frailty using the Clinical Frailty Scale may support patient-centred decision-making and tailored care strategies.