Perioperative medicine & outcomes
Decision-making processes in older patients that require, but do not undergo, emergency laparotomy in the UK: a multicentre observational study
Authors' conclusion
Multispeciality, shared decision-making regarding emergency laparotomy is possible in a time-pressured emergency surgical setting.
Study context
- Population
- Older adults (≥65 yr) who require, but do not undergo, emergency laparotomy (NoLap), 64 UK emergency surgical units, February-November 202164 UK units
- Participants
- 750 adults
- Outcome
- Decision-making process behind the decision not to operate (shared and multispeciality decision-making)
Methodological detailsmulticentre, observational, qualitative analysis of free text
- Multicentre
- Observational
- Qualitative analysis of free text
Main finding
As reported in the abstract
Decision-making in NoLap cases
- Advanced directive
- 12.4%
- Patient involvement in decision documented
- 65.9%
- Patient involvement assisted by a family member
- 34.4%
- Patient not involved
- 33.2%
- Family member consulted when patient not involved
- 67.5%
- Neither patient nor family member involved
- ≥9.0%
- Multispeciality decision-making
- 66.2%
- Surgical team involved
- 99.9%
- Surgical team at consultant level
- 84.8%
- Surgical team in person
- 73.5%
- Medical teams involved
- 33.0%
- Geriatricians present
- 8.7%
Observational data: associations, not effects.
Further findings
Qualitative content analysis
- Broad range of patient and clinical factors identified warranting further exploration
Original publication
Decision-making processes in older patients that require, but do not undergo, emergency laparotomy in the UK: a multicentre observational study. Br J Anaesth. Published 14 May 2026. doi:10.
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