Peri-Operative Surgical Care Optimisation for Patients Requiring Emergency Surgery

Launched by NHS GREATER GLASGOW AND CLYDE · May 6, 2025

Keywords

ClinConnect Summary

This clinical trial is looking at how emergency surgeries affect patients' quality of life and the decision-making process for both patients and doctors. Emergency general surgery (EGS) involves urgent operations for serious abdominal problems, and while many patients survive, they often face new health challenges that can lower their quality of life. The researchers want to understand the experiences of patients who had these surgeries, those who needed them but did not have them, and the doctors involved in their care. They will gather information through questionnaires and interviews over several months to learn more about how these decisions are made and how patients and their families feel about the outcomes.

To participate, patients must be over 65 years old, able to communicate in English, and have had or needed emergency surgery on their digestive system. Family members or supporters who are nominated by the patient can also join the study, as well as doctors who regularly make decisions about emergency surgeries. Participants can expect to share their experiences through surveys and interviews, which will help improve understanding and care for future patients facing similar situations.

Gender

ALL

Eligibility criteria

• • Group 1 and 2: EmLap and NoLap patients (up to 30 participants)
• • Patient inclusion/exclusion criteria should mirror NELA inclusion/exclusion criteria and NELA NoLap guidelines. NELA is the "National Emergency Laparotomy Audit" which recruits patients in Wales and England and there inclusion/exclusion criteria are widely accepted for use in Emergency General Surgery research.
• • Inclusion criteria
• • Age \>65 years old
• • Able to communicate in English
• • Cognitively able to complete the survey/interviews
• • Able to provide informed, voluntary consent
• • First line treatment is expedited, urgent or emergency abdominal surgery on the gastrointestinal tract
• • Surgery can be laparoscopic or open approach
• • Exclusion criteria
• • Age \<65 years old
• • NoLaps should be excluded if management involved interventional radiology or endoscopic procedures
• • Patients who are offered a period of conservative treatment are not automatically NoLap if surgery may ultimately be offered
• • Diagnosis of dementia or long-standing cognitive impairment
• • Elective laparotomy/laparoscopy
• • Diagnostic laparotomy/laparoscopy where no subsequent procedure is performed (however, if no procedure is performed because of inoperable pathology, then include)
• • All surgery involving the appendix or gallbladder, including any surgery relating to complications
• • Non-elective hernia repair without bowel resection or division of adhesions
• • Non-elective formation of colostomy or ileostomy
• • Trauma surgery (blunt or penetrating), vascular surgery, obstetric/gynaecological surgery or transplant surgery
• • Surgery for pathology of oesophagus, spleen, renal tract, kidneys, liver, gallbladder and biliary tree, pancreas or urinary tract
• • Group 3: Families/Supporters (up to 30 participants) Inclusion criteria
• • Identified by the patient participant (only approached if nominated by patient)
• • Age \>18 years old
• • Able to communicate in English
• • Cognitively able to complete the survey/interviews
• • Able to provide informed, voluntary consent
• • Exclusion criteria
• • Age\<18 years old
• • Lack of patient consent to family/supporter involvement
• • Group 3: Consultants (interview:12-20 participants/survey: minimum 52 participants) Inclusion criteria
• • Key decision-makers will be identified in workstream 1 (likely: surgeons, intensivists and anaesthetists)
• • Post-CCT (Certificate of Completion of Training)
• • Participate in active on-call for EGS in a UK-based Hospital where they make decisions in EGS regularly
• • Exclusion criteria
• • • Consultants not done \>2 years of on-call