320IMPROVING EMERGENCY ABDOMINAL SURGERY OUTCOMES WITH ERAS PROTOCOLS: A COHORT STUDYEnhanced Recovery after Surgery (ERAS) protocols aim to improve outcomes and expedite recovery for patients undergoing abdominal surgery. This study evaluates the implementation of an ERAS protocol in a large cohort of patients undergoing emergency abdominal surgery, focusing on compliance factors and postoperative outcomes. The study involved 589 patients who underwent abdominal resections with anastomoses for intestinal infections and obstructions. Over a 30-day follow-up, there were 45 major complications and six deaths (15.6%). Key ERAS interventions included the removal of nasogastric tubes and urethral catheters by postoperative day 2, and the management of fluid intake. Factors negatively affecting protocol compliance included laparoscopic surgery, preoperative hyperglycemia, the presence of abdominal drains, prolonged surgery duration, and major complications. The findings highlight the challenges and benefits of ERAS implementation in emergency settings, underscoring the importance of managing hyperglycemia and fluid balance for optimal recovery. This study demonstrates that ERAS protocols can be successfully integrated into emergency abdominal surgeries, potentially enhancing patient recovery and reducing morbidity and mortality ratesSrividhya S@gmail.comResearch922018Enhanced Recovery After Surgery (ERAS), Emergency Abdominal SurgeryDr. Srividhya SAssistant Professor, Department of General Surgery, Sri Lakshminarayana Institute of Medical Sciences, Puducherry, India