SNAP3: Frailty & delirium

• Research type

  Research Study

• Full title

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

• IRAS ID

  294618

• Contact name

  Iain Moppett

• Contact email

  iain.moppett@nottingham.ac.uk

• Sponsor organisation

  University of Nottingham

• Duration of Study in the UK

  10 years, 6 months, 0 days

• 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.

• REC name

  Wales REC 7

• REC reference

  21/WA/0203

• Date of REC Opinion

  28 Jun 2021

• REC opinion

  Favourable Opinion