Problem addressed, background and strategic significance
More than half of patients having emergency abdominal surgery are now aged over 65 years. These vulnerable patients have different health needs than younger patients which can make getting better after surgery difficult. It can take longer and can result in patients being unable to do things for themselves (greater dependence). This may mean they need extra help at home on discharge or are unable to return to their own home (care home)). Doctors call this vulnerability ‘frailty’. It is important that doctors recognise frailty and try to develop ways to make patients less vulnerable (frail) and to improve their health outcomes.
We will collect information on 500 patients (patients’ medical history, their independence, a measure of frailty (score), days spent in hospital, complications after surgery, readmission to hospital after surgery, or if they pass away within 90 days of surgery), admitted to 46 UK NHS Hospitals. The scoring system is simple and reliable and will not interfere in the patients care. With the information we collect we will be able to say how older patients frailty affects them when the have unplanned emergency surgery.
Hoped for results of this research
Recognising and quantifying frailty will allow us to understand the risks of surgery and post-operative recovery and could help surgeons, patients and their families make decisions about what kind of surgery to perform and how best to care for patients after their operation.
How will this project help build on the Delphi question and what further plans are proposed for future development?
Patients played a key part in the development of Delphi questions. This study is very focused on identifying patient related outcomes with a future aim of developing strategies to improve short and long-term outcomes for older patients. By assessing older adults we are selecting an expanding group of complex medical patients to whom independence and return to baseline function can be compromised by surgery.