Objective:

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.

Approach:

• Study Design: Single-center cohort study of patients aged ≥75 years undergoing emergency abdominal surgery at a Norwegian university hospital.
• Assessment Methods: Preoperative assessments included frailty (Clinical Frailty Scale), comorbidity (Charlson Comorbidity Index), and residence status. Survivors were followed up after one year via telephone, using the EQ-5D-3L questionnaire.

Key Findings:

• 135 out of 154 patients (88%) were discharged alive from the hospital.
• At follow-up, 106 out of 154 patients (69%) were alive, with 74 (70%) completing the questionnaire.
• The follow-up cohort was younger, with a median age of 79 (IQR 77–84) compared to 83 (IQR 79–88) in the non-assessable cohort.
• The follow-up cohort had a lower Charlson Comorbidity Index score of 5 (IQR 4–6) compared to 6 (IQR 5–8) in the non-assessable cohort.
• In the follow-up cohort, 96% had returned home.
• 43% reported mobility problems, 12% had issues with self-care, and 36% faced difficulties with usual activities.
• 46% reported some or extreme pain or discomfort, and 34% experienced anxiety or depression.
• 73% reported improved or unchanged health status, and 77% were willing to undergo emergency abdominal surgery again.

Interpretation:

One year after emergency abdominal surgery, half of the patients were alive and able to report their recovery status, with functional recovery and health-related quality of life comparable to Norwegian reference populations.

Limitations:

• Selection and response biases were present, as the frailest patients were unable to participate or did not survive to follow-up assessment.

Conclusion:

The findings indicate that a significant proportion of older patients report satisfactory health-related quality of life and functional outcomes one year post-surgery.