• Andrea Spota, Stefano Piero Bernardo Cioffi, Michele Altomare, Hayato Kurihara, Eisar Al-Sukhni, Lewis J Kaplan, and Gary Alan Bass.
• Acute Care Surgery Research Fellow, UHN Toronto General Hospital, Toronto, ON, Canada. a.spota89@gmail.com.
• Eur J Trauma Emerg Surg. 2025 Jan 24; 51 (1): 4646.

PurposeOur study explores the utilization of objective tools for preoperative assessment of elderly patients by Emergency General Surgeons (EGS).MethodsA descriptive cross-sectional survey was conducted via the European Society for Trauma and Emergency Surgery (ESTES) Research Committee. EGS were invited through the ESTES members' mailing list and social media platforms. The survey included two sections: (1) clinical scenarios involving elderly patients with varying chronic conditions, and (2) participant characteristics. Data collection lasted 12 weeks, with reminders sent every 4 weeks. Statistical analyses were performed using Microsoft Excel and EasyMedStat.ResultsOne hundred and seven surgeons responded to the survey. Median respondent age was 41 years, with a male prevalence (72.9%). Most participants were from Europe (85%). Key-findings included that 62.6% reported using one or more risk assessment tools (RATs), while 35.5% used one or more frailty scores. Additionally, 4.7% were unaware of any RATs, and 35.5% were unaware of any frailty scores. Decision-making strategies leveraging personal experience with minimal impact from RATs predominated.ConclusionsPreoperative risk assessment tool and frailty score use for elderly patients requiring emergency surgery remains limited among ESTES surgeons. Our study highlights the need for focused education and tool workflow integration to improve risk stratification, decision-making and outcomes. Institutional approaches coupled with targeted educational interventions using implementation science principles are recommended to bridge this knowledge-to-action gap. Future research should focus on developing comprehensive, user-friendly tools and evaluating their impact on patient-centered outcomes.© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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