Perioperative Medicine for Older People Undergoing Surgery Scale Up (POPS-SUp): study protocol

作者：Jugdeep Dhesi, Judith Partridge, Bridget C. Strasser, Lindsay Bearne, Nathan Hall, Andrew Healey, John S M Houghton, Laura Magill, Bijan Modarai, Iain Moppett, Lawrence Mudford, John Norrie, Rupert M. Pearse, Thomas Pinkney, Athanasios Saratzis, Robert Sayers, Cecilia Vindrola‐Padros, Justin Waring · 发表于：BJS Open · 年份：2025 · DOI：10.1093/bjsopen/zraf063 · 被引用次数：2 · 研究领域：Frailty in Older Adults、Cardiac, Anesthesia and Surgical Outcomes、Enhanced Recovery After Surgery

BACKGROUND: Surgery provides definitive management of many age-related diseases, relieving symptoms or extending life. Age-related physiological decline, multimorbidity, and frailty predispose older people to postoperative complications and incomplete functional recovery, with resultant health and social care costs. These age-related conditions can be optimized using Comprehensive Geriatric Assessment (CGA), thus mitigating perioperative risk to improve clinical outcomes with cost-effectiveness. National organizations advocate CGA-based services for older surgical patients. However, there is variation in the provision of CGA-based perioperative medicine for older people undergoing surgery (POPS) services across the UK National Health Service, resulting in inequitable access for older surgical patients at higher risk, unnecessary deaths, complications, and financial cost. The aim of the POPS Scale Up (POPS-SUp) study is to determine whether CGA-based POPS services can be implemented at scale to cost-effectively improve clinical outcomes for older patients undergoing surgery. METHODS: A mixed-methods hybrid implementation-effectiveness interrupted time series study will examine the use of a coproduced implementation strategy to embed CGA-based POPS services at scale in the UK. Co-primary implementation-effectiveness outcomes will be used, namely reach and length of hospital stay, respectively. Evaluation will include an embedded process evaluation, quantitative evaluation of cl...