Evidence map›Paper›PMID 40389332›Full record

ArticleBritish journal of anaesthesia2025

A survey of perioperative medicine services with a focus on provision for older surgical patients in the UK and Republic of Ireland: SNAP-3.

Claire J Swarbrick, Amy Donnelly, SNAP-3 collaborators, Karen Williams, Andrea Haren, Bob Evans, Thomas Poulton, Akshay Shah, Judith S L Partridge, Iain K Moppett

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Observational
  3. Article
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Claire J SwarbrickAnaesthesia and Critical Care, Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UK; Centre for Research and Improvement, Royal College of Anaesthetists, London, UK; Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK. Electronic address: Claire.swarbrick@nottingham.ac.uk.
Amy DonnellyVincent's University Hospital, Dublin, Republic of Ireland.
SNAP-3 collaborators
Karen WilliamsCentre for Research and Improvement, Royal College of Anaesthetists, London, UK.
Andrea HarenVincent's University Hospital, Dublin, Republic of Ireland.
Bob EvansPatient, Carer and Public Involvement and Engagement, Royal College of Anaesthetists, London, UK.
Thomas PoultonDepartment of Anaesthesia, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia; Research Department of Targeted Intervention, University College London, London, UK.
Akshay ShahNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Department of Anaesthesia, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
Judith S L PartridgePerioperative Medicine for Older People Undergoing Surgery (POPS), Guy's and St Thomas' NHS Foundation Trust, London, UK; School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College Hospital, London, UK.
Iain K MoppettAnaesthesia and Critical Care, Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UK; Centre for Research and Improvement, Royal College of Anaesthetists, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerioperative medicine aims to improve care for high-risk patients, and is endorsed by national guidelines in the UK and Republic of Ireland (ROI). However, comprehensive perioperative medicine services are not yet uniformly available. This survey addressed the current state of perioperative medicine services for older surgical patients in the UK and ROI and how these services align with current national guidance.

methodsA survey was distributed electronically to all publicly administered UK and ROI hospitals performing surgical procedures. The survey examined perioperative care against national recommendations regarding service organisation and conduct.

resultsOf 339 eligible hospitals, 54.9% (186/339) responded. A hospital frailty lead was appointed in 54% (101/186) of hospitals, and 9% (16/186) had a designated anaesthetist for cognitive impairment. Hospital anaesthetic services outside the theatre were focused on preoperative assessment clinics (146/172), with few reporting routine postoperative involvement (17/166). Nurse-led preoperative assessments of frailty, cognition, and delirium risk were conducted in 49.5% (90/182), 44.3% (78/176), and 13.7% (24/175) of hospitals, respectively. The Clinical Frailty Scale was used in 87.0% (147/169) of hospitals for frailty screening. The 4 'A's Test (45.7% [85/186]) and Abbreviated Mental Test (43.0% [80/186]) were the preferred cognitive assessment tools.

conclusionsThe survey highlights the variation in perioperative medicine services that exist for older surgical patients despite national guidelines advocating their widespread implementation. Opportunity exists to develop interspecialty perioperative services further and promote identification of frailty, cognitive impairment, and delirium, all of which negatively impact postoperative outcomes for older surgical patients.

Indexed as

Perioperative CarePerioperative MedicineAgedAged, 80 and overFrailtyGeriatric AssessmentHealth Care SurveysHumansIrelandSurveys and QuestionnairesUnited Kingdomageingfrailty syndromegeriatric medicinehealth servicesmanpowerperioperative caresurgery

Identifiers

PMID40389332
PMCPMC12226739

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.