Emergency Laparotomy and Frailty (ELF)
Research type
Research Study
Full title
Emergency Laparotomy and Frailty- a national multi-centre study of frail older surgical patients undergoing emergency laparotomy (ELF)
IRAS ID
215903
Contact name
Susan Moug
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Clinicaltrials.gov Identifier
NCT02952430, Registered at www.clinicaltrials.gov
Duration of Study in the UK
0 years, 4 months, 1 days
Research summary
Emergency laparotomies are performed on the most unwell patients for a variety of serious surgical conditions. Unsurprisingly, morbidity and mortality can be high supporting the need for research to improve patients' outcomes. The objective of the ELF study is to establish if using a frailty score can help predict outcomes in emergency laparotomies performed on patients aged 65 and over.
This research question is relevant because a recently published large national audit has shown that over half of patients undergoing emergency laparotomies are aged over 65 years and are at greater risk of complications and death when compared to younger adults. There are risk prediction tools that aim to predict surgical outcomes, but these are mostly derived from research in younger patients and may not be relevant in older patients.
Frailty scores are a relatively recent development. They are validated and simple to perform. Recent publications have shown that higher frailty scores correlate with a number of outcomes in elective operations: increased post-operative mortality, post-operative complications, length of hospital stay and likelihood of institutionalisation. There is limited work in the emergency high-risk setting. Knowledge of whether these frailty scores correlate with outcomes in the older emergency surgical patient could assist doctors and patients in making optimal treatment decisions leading to improved patient care.
The ELF study aims to add to the current research by assessing the use of one specific validated frailty score (the Rockwood scale) in patients 65 and over undergoing emergency laparotomies by means of an observational national multicentre cohort study. Anonymised data will be collected from participating NHS hospitals throughout England, Scotland and Wales and analysed by the lead statistician working with ELF. The findings will then be distributed via presentations at a national surgical conference and publication in a peer-reviewed journal.
REC name
West Midlands - Black Country Research Ethics Committee
REC reference
16/WM/0500
Date of REC Opinion
29 Nov 2016
REC opinion
Favourable Opinion