A study to describe recovery of older people after cardiac surgery.
Research type
Research Study
Full title
An observational study to describe postoperative functional recovery in older people undergoing cardiac surgery.
IRAS ID
193557
Contact name
Deep Dhesi
Contact email
Sponsor organisation
Guy's and St THomas' NHS Foundation Trust
Duration of Study in the UK
5 years, 0 months, 2 days
Research summary
Research Summary
- Observational Study
The purpose of this study is to describe postoperative recovery in older people. We are particularly interested in the change in a person’s ability to perform activities that are important to them after surgery. These activities will range from washing & dressing through to using public transport or caring for loved ones. We will look at how changes may be affected by particular medical conditions or personal circumstances. This will allow us to gain a better understanding of how surgery affects patient’s day-to-day lives in the ‘medium to long-term’. We already know quite a bit about what happens in the ‘short-term’ i.e. immediately after operations and before people are discharged home.The questions older people most commonly ask are:
- How well will I recover after surgery?
- How long will my recovery take?
- What quality of life will I have in the months and years afterwards?This study will hopefully give us some of the information we need to provide a better answer.
This study is ‘observational’ which means that we will be collecting information about what is happening , in 6 months, and at 5 years after the operation. The study will not involve any changes to the care currently given to people undergoing these operations. No experimental medicines will be used. We hope that the results of this study will show us areas where we can intervene to improve the longer-term outcomes and quality of life for people undergoing these operations in the future.
- Nursing Survey
as part of understanding how patients recover from surgery, we wish to understand how nurses deliver care to patients on the wards. We are particularly interested in the management of delirium (otherwise known as acute confusion state) after cardiac surgery.This study will include a survey to assess the knowledge, behaviour and attitudes of nursing staff.
Summary of Results
This study looked at what happens to older people in the years after major heart surgery. We were particularly interested in day to day functioning and in memory and thinking skills over the five years after surgery.
We followed 98 patients aged 60 and over who were having planned heart bypass surgery. Before their operation patients saw a geriatrician (a doctor specialising in the care of older people) who assessed their general health, level of frailty and memory and thinking. Frailty is a way of describing how vulnerable someone is to stress, for example because of weakness, low activity or low reserve. After surgery we checked on people’s ability to manage everyday activities, their memory and thinking and their quality of life at discharge, six weeks, six months and five years.
Around one in five patients had died within five years of surgery. Among those who were still alive, most people’s ability to manage everyday activities dropped just after the operation but recovered by six months and was better than before surgery at five years. In contrast, on average memory and thinking scores got worse over time. Patients who were more frail or who already had some problems with memory and thinking before surgery were more likely to have a slower recovery and a higher chance of dying in the five years after their operation.
These results suggest that careful preoperative assessment by a geriatrician can help to identify patients at higher risk, guide targeted support before and after surgery and provide better information for shared decision making with patients and their families.
REC name
London - Harrow Research Ethics Committee
REC reference
17/LO/0160
Date of REC Opinion
29 Jun 2017
REC opinion
Further Information Favourable Opinion