Surgeons need to recognize unique diagnostic hurdles when treating older adults in emergency general surgery, as these can lead to worse outcomes.

• Key challenges identified include atypical presentations, multiple comorbidities, and age-related complications.
• Emphasis on non-diagnostic factors like functional health, patient preferences, and family involvement must not be overlooked.

Tailoring strategies, like using surgical risk calculators and multidisciplinary teams, could enhance diagnostic accuracy.

• Practitioners highlighted barriers to implementing these tools, signaling a need for quality improvement in surgical care for this demographic.