eprintid: 10184658 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/18/46/58 datestamp: 2024-01-04 14:03:22 lastmod: 2024-01-04 14:03:22 status_changed: 2024-01-04 14:03:22 type: article metadata_visibility: show sword_depositor: 699 creators_name: Swarbrick, Claire creators_name: Poulton, Tom creators_name: Martin, Peter creators_name: Partridge, Judith creators_name: Moppett, Iain Keith creators_name: SNAP 3 Project Team, title: Study protocol for a national observational cohort investigating frailty, delirium and multimorbidity in older surgical patients: the third Sprint National Anaesthesia Project (SNAP 3) ispublished: pub divisions: UCL divisions: B02 divisions: D12 divisions: G21 keywords: Adult anaesthesia, Adult surgery, Dementia, GERIATRIC MEDICINE, Health Services for the Aged, Humans, Aged, Frailty, Multimorbidity, Quality of Life, Research Design, Anesthesia, Delirium, Observational Studies as Topic note: http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. abstract: INTRODUCTION: Older surgical patients are more likely to be living with frailty and multimorbidity and experience postoperative complications. The management of these conditions in the perioperative pathway is evolving. In order to support objective decision-making for patients, services and national guidance, accurate, contemporary data are needed to describe the impact and associations between frailty, multimorbidity and healthcare processes with patient and service-level outcomes. METHODS AND ANALYSIS: The study is comprised of an observational cohort study of approximately 7500 patients; an organisational survey of perioperative services and a clinician survey of the unplanned, medical workload generated from older surgical patients. The cohort will consist of patients who are 60 years and older, undergoing a surgical procedure during a 5-day recruitment period in participating UK hospitals. Participants will be assessed for baseline frailty and multimorbidity; postoperative morbidity including delirium; and quality of life. Data linkage will provide additional details about individuals, their admission and mortality.The study's primary outcome is length of stay, other outcome measures include incidence of postoperative morbidity and delirium; readmission, mortality and quality of life. The cohort's incidence of frailty, multimorbidity and delirium will be estimated using 95% CIs. Their relationships with outcome measures will be examined using unadjusted and adjusted multilevel regression analyses. Choice of covariates in the adjusted models will be prespecified, based on directed acyclic graphs.A parallel study is planned to take place in Australia in 2022. ETHICS AND DISSEMINATION: The study has received approval from the Scotland A Research Ethics Committee and Wales Research Ethics Committee 7.This work hopes to influence the development of services and guidelines. We will publish our findings in peer-reviewed journals and provide summary documents to our participants, sites, healthcare policy-makers and the public. TRIAL REGISTRATION NUMBER: ISRCTN67043129. date: 2023-12-21 date_type: published publisher: BMJ official_url: http://dx.doi.org/10.1136/bmjopen-2023-076803 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2135837 doi: 10.1136/bmjopen-2023-076803 medium: Electronic pii: bmjopen-2023-076803 lyricists_name: Martin, Peter lyricists_id: PMART69 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: BMJ Open volume: 13 number: 12 article_number: e076803 event_location: England issn: 2044-6055 citation: Swarbrick, Claire; Poulton, Tom; Martin, Peter; Partridge, Judith; Moppett, Iain Keith; SNAP 3 Project Team; (2023) Study protocol for a national observational cohort investigating frailty, delirium and multimorbidity in older surgical patients: the third Sprint National Anaesthesia Project (SNAP 3). BMJ Open , 13 (12) , Article e076803. 10.1136/bmjopen-2023-076803 <https://doi.org/10.1136/bmjopen-2023-076803>. Green open access document_url: https://discovery-pp.ucl.ac.uk/id/eprint/10184658/1/e076803.full.pdf