Problem addressed, background and strategic significance

Improving emergency surgery outcomes particularly in the elderly is a key priority for the NHS. More and more people are living into old age and developing multiple medical conditions, long-term disabilities and frailty. Those admitted with surgical emergencies are increasingly difficult to treat and may not be fit enough for standard surgery. If they do undergo surgery, they do not tend to do as well as younger patients.

Method(s) used

The study will collect detailed information on a group of elderly patients from when they arrive in hospital, about the preparation for emergency surgery, what happens to them afterwards and following them up for 6 months after discharge. Information includes events leading up to hospital admission, choice of operation and what risk or fitness assessments were carried out, questionnaires about quality of life, return to previous activities, healthcare usage and cost to the NHS. Some patients, their relatives and healthcare professionals will be interviewed to explore how they feel that care could be improved

Hoped for results of this research

This study will be the first to look in detail at the entire pathway for older emergency surgical patients. In collaboration with colleagues from other disciplines involved in the care of these patients we will identify which aspects of care could be improved and how. Ultimately we hope to be able develop an enhanced pathway of care for these patients, to be tested in a larger trial.

What this research is expected to add to the knowledge of bowel disease and what is the impact you hope to achieve for patients?

Elderly patients presenting with emergency bowel problems have not been studied extensively. And yet, because the outcomes are generally poorer than younger patients or those undergoing planned surgery, this is an area desperate for improvement. It is hoped that this project, through mapping different pathways in detail, will identify areas where improvements can be made and tested to improve these outcomes.