Problem addressed, background and strategic significance

Improving gastrointestinal (GI) surgery outcomes, particularly in the older population, 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 presenting with GI pathology 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 background health information on a group of older patients from when they are first referred to GI surgeons, what strategies are used to try to ensure that they make a good recovery after surgery, what type of operation they undergo and whether they have any problems whilst in hospital and follow them up for 6 months after discharge. Information includes how healthy and independent they are before any intervention, choice of operation and what risk or fitness assessments were carried out, questionnaires about quality of life and return to independent living. Some patients 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 GI surgical patients, both planned and emergency. 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 interventions for these patients, to be tested in a larger study.

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

Older patients presenting with GI problems requiring surgery have not been studied extensively, and yet, because the outcomes are generally poorer than younger patients, this is an area desperate for improvement. It is hoped that this project, through mapping different pathways in detail and assessing patients thoroughly at different time points, will identify areas where improvements can be made and tested to improve these outcomes.