This July, I had the opportunity to present my research at the 2026 Annual Meeting of at ICC Belfast — one of the largest bowel surgery meetings in the UK and Ireland. My talk asked a question that matters to patients as much as to surgeons: after major emergency surgery, can we predict not just whether someone survives, but how well they recover?
Emergency laparotomy is major, unplanned surgery to open the abdomen, often to treat life-threatening problems such as a blocked or perforated bowel. Because these operations carry real risk, surgical teams use scoring tools to estimate how a patient is likely to do. The most widely used in the UK is , which mainly predicts the risk of dying within 30 days. Another is the Clinical Frailty Scale (CFS), a simple nine-point measure of how fit or frail a person is before they become unwell. But survival is only part of the story — for many patients, what matters just as much is whether they can walk, wash and live independently again. We set out to compare NELA and the CFS to see which better predicted this “functional recovery”, using data from .
We studied 437 patients aged 65 and over. Around one in ten did not survive the first 30 days; among the 395 who did, nearly one in five had not recovered a month later — still in hospital, or discharged needing more care than before. Reassuringly, both tools could predict this — but NELA did it better: on a standard measure of accuracy, where 0.5 is no better than a coin-toss and 1.0 is perfect, it scored 0.75 versus 0.64 for the CFS, a clear and statistically significant difference. The take-home message is that looking “beyond mortality” could help teams give patients more honest, personalised information about life after surgery, and direct extra support to those most likely to need it.
Although this is surgery, much of the risk assessment sits with anaesthetists: the NELA score is worked out before the operation and used across perioperative medicine — the care of patients before, during and after surgery. As someone hoping to become an anaesthetist, I found it exciting that a simple bedside score might strengthen the conversations we have with patients about the recovery that matters most to them.
Presenting at the ACPGBI Annual Meeting in Belfast, on the banks of the River Lagan, was a real highlight of my final year. Standing up in front of experienced surgeons was daunting, but the questions afterwards were generous and thought-provoking, and it was rewarding to see student research taken seriously at a national meeting.
I am grateful to the 51cg for supporting me to attend, and to my supervisor Mr George Ramsay and his team for the guidance.
