LAUSR

Abstract Background Increasing numbers of older people undergo emergency hospitalisation and surgery. The benefits of a comprehensive multidisciplinary service for older adults have not been evaluated. This prospective, single centre study describes patient characteristics and clinical outcomes of older people admitted under general surgery as an emergency. Material and methods Between 9th September 2014 and 30th November 2015, 300 consecutively admitted patients received input from the liaison service. Results Seventy patients (23.3%) underwent surgery, 82 (27.3%) a non-surgical procedure, and 148 (49.3%) were managed non-invasively. Mean age was 82.5 years (70–98), 55.7% were female, most lived in their own home (90.7%), and were independent in basic (77.5%) and instrumental (52.5%) activities of daily living. A total of 46.3% mobilised with no walking aids or using a stick. Patients had 5.2 chronic conditions and took 8.6 medications on average. Thirteen point seven percent had a diagnosis of dementia. Liver and biliary conditions (23%) and cancer (19.3%) were the most common diagnoses. Mean LOS fell from 14.6 to 12.5 days, and median LOS from 11 to 7 days after the service became fully established (February 1st 2015). Thirty-day readmission rate was 14.3% (40/279). Mortality rates in hospital, 30-days after hospital admission, 30-days after surgery and 30-days postdischarge were 7%, 8.7%, 8.6% and 5.4%. Conclusions Older individuals admitted non-electively under general surgery often have cognitive or functional impairment and complex social issues. A geriatrician-led liaison service benefits length of stay, facilitates recognition of complications, enhances management of multimorbidity and polypharmacy and drives discharge planning.