Health-related quality of life and functional recovery one year after emergency abdominal surgery in patients over 75 years: a prospective observational study.

Introduction: Emergency abdominal surgery is common in older patients, yet data on long-term patient centered outcomes are scarce, limiting informed decision making for this vulnerable population. The aim of this study was to investigate functional outcomes in older patients one year after emergency abdominal surgery, including residence status, perceived health, willingness to repeat the procedure, and health-related quality of life. Methods: Single-center cohort study of patients aged ≥75 years undergoing emergency abdominal surgery at a Norwegian university hospital. Preoperatively, patients were assessed for frailty (Clinical Frailty Scale), comorbidity (Charlson Comorbidity Index) and preoperative residence status. Survivors were followed up after one year by telephone. Health-related quality of life was assessed by the EuroQol Five Dimensions Three Levels (EQ-5D-3L) questionnaire. Results: Of 154 patients undergoing emergency abdominal surgery, 135 (88%) were discharged alive from hospital. At follow-up, 106/154 (69%) were alive. Of those, 74 (70%) completed the questionnaire. The follow-up cohort was younger [median age 79 [IQR 77-84] vs. 83 [IQR 79-88]; Conclusion: One year after emergency abdominal surgery in older patients, half of the patients were alive and able to report their recovery status. Functional recovery and health-related quality of life were comparable to Norwegian reference populations, and three of four would choose emergency surgery again. The findings are subject to selection and response biases, as the frailest patients were unable to participate or did not survive to follow-up assessment.