How do we define and identify high-risk surgical patients
Research type
Research Study
Full title
Defining and identifying the elective high risk general surgical patient – do all the relevant parties’ perceptions add up?
IRAS ID
355125
Contact name
Susan Moug
Contact email
Sponsor organisation
University of Glasgow
Duration of Study in the UK
0 years, 8 months, 0 days
Research summary
BACKGROUND The current definition of 'high-risk' general surgical patients is based on a 5 in 100 chance of dying. This definition does not accurately reflect the differences between elective (planned) and emergency surgeries, or variations across specialties. Emergency surgery patients generally have different characteristics that make them more high-risk compared to those undergoing planned surgery. The actual risk of dying from planned surgery is lower than this definition suggests, but there are other complications that are more likely and impactful, which are not considered. The impact of these complications on patients' lives is also not accounted for in this definition. Labelling a patient as high-risk triggers important care decisions. Understanding what "high-risk" means to patients and the likely outcomes of their surgeries will help create a more accurate definition. This will ensure consistent identification and management and improve the consent process.
AIMS This study aims to redefine 'high-risk' general surgical patients by incorporating patients' understanding and actual outcomes of those undergoing surgeries.
REASONING There is likely to be a difference in the way patients and clinicians view risk and what outcomes are included in risk prediction tools. This project will provide valuable insights into these differences and help ensure that patients at risk of more likely and impactful outcomes are consistently identified and managed appropriately.
APPROACH This is a mixed methods prospective study. Adults who had pancreas, oesophagus, or bowel surgery for cancer in the last year and are now out of hospital will be invited to join focus groups. They’ll receive an information pack when recruited. The groups will discuss the "high-risk" label and its impact on decision-making. Four focus groups will be held, either all in person or all online, based on the majority's preference. Each group will include 6-8 participants, who are welcome to bring a support person.
REC name
North of Scotland Research Ethics Committee 2
REC reference
25/NS/0064
Date of REC Opinion
17 Jun 2025
REC opinion
Favourable Opinion