Sprint National Anaesthesia Project 3: an observational study of frailty, multimorbidity and delirium in older people in the perioperative period (SNAP3)

Research summary

BACKGROUND More older people are undergoing surgery as the population ages and surgical care improves. Frailty is an age-related syndrome that increases an individual's vulnerability to adverse outcomes in response to illness, injury and surgery. Delirium is a period of temporarily altered, fluctuating consciousness, triggered by illness, surgery or environment. There is evidence that surgical outcomes are worse in patients with these conditions. AIMS The purpose of SNAP3 is to investigate which patients are frail and which are at risk of delirium. It will investigate current perioperative care and its outcomes. METHODOLOGY Our research includes three parallel studies which will run in NHS hospitals within the UK. S2 and S3 are service evaluation surveys for clinicians and are included for completeness: S1 Prospective, observational study of approximately 12,000 surgical patients who are at least 60 years old S2 Organisational survey of preoperative and postoperative care S3 Survey of acute referrals and interventions to medical doctors and geriatricians S1 participants recruited will have the following information collected: -Notes review and data linkage with government agencies, for demographic, medical and socioeconomic details -Frailty assessments: 2 requiring active participant involvement, 2 using electronic medical records -Assessments for delirium and perioperative complications -Quality of life telephone survey 4 months postoperatively. OUTCOMES We will report the proportion of patients with frailty, multiple medical problems and delirium. We will identify relationships between management and outcomes. We will investigate how to predict who will develop delirium and how we can manage this. IMPACT Our dataset will hopefully provide evidence to direct resources to manage frailty and delirium in the best way possible. We hope to understand what constitutes excellent care for frail patients, those with multiple medical problems and those at risk of delirium. We will develop a tool that to alert clinicians to those at risk of delirium early in the surgical pathway, so that they can be actively managed.

Principal Investigator

Dr Akshay Shah

Contact us

Email: crndirectdeliveryteam@ouh.nhs.uk

IRAS number

294618