Observational studyBritish journal of anaesthesia2025
Postoperative outcomes in older patients living with frailty and multimorbidity in the UK: SNAP-3, a snapshot observational study.
Observational study 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 19 papers.
What it found
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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.
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.
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Who cites it
19 citing papers in PubMed.
- Long-Term Cognitive and Functional Outcomes of Anesthesia and Surgery in Patients with Dementia.Healthcare (Basel, Switzerland) · 2026Review
- Short-term safety and efficacy of revision or conversion metabolic and bariatric surgery in older adults: an analysis of the MBSAQIP database.Surgical endoscopy · 2026Article
- RERAS: does age define recovery? The role of patient characteristics and ERAS protocols in robotic colorectal surgery.Journal of robotic surgery · 2026Article
- Frailty in emergency surgery: expanding the role of biomarkers.Annals of the Royal College of Surgeons of England · 2026Article
- Long-Term Functional Outcomes After Prehabilitation in Frail Older Adults Undergoing Colorectal Cancer Surgery: A One-Year Prospective Cohort Study.Journal of clinical medicine · 2026Article
- Postoperative outcomes in older patients with postoperative delirium in the UK: SNAP-3, a snapshot observational study.British journal of anaesthesia · 2026Observational
- Individualized Enhanced Recovery After Surgery (ERAS) and physiological resilience in a 101-year-old patient undergoing laparoscopic cholecystectomy: a case report.BMC geriatrics · 2026Article
- Recovery Experiences of Older Adults and Their Caregivers After Major Elective Noncardiac Surgery.JAMA network open · 2026Article
- Feasibility of preoperative patient self-assessed frailty: a single-centre pilot study.BJA open · 2026Article
- Interest of the Robotic Approach for Pancreaticoduodenectomy in Elderly Patients in a Setting of Limited Robotic Platform Access: A Propensity Score-Matched Comparison with Open Surgery.Journal of clinical medicine · 2026Article
- Association of intraoperative dexamethasone administration with postoperative delirium and the role of hyperglycaemia: a retrospective cohort study.EClinicalMedicine · 2026Article
- Delirium after cardiac surgery incidence and perioperative risk factors in a prospective cohort.Journal of cardiothoracic surgery · 2026Article
- Impact of anesthesia methods on adverse cardiovascular events during painless gastroscopy in frail older patients: study protocol for a prospective controlled trial.Frontiers in medicine · 2026Article
- Early oral nutritional supplementation and postoperative recovery after hip arthroplasty in malnourished older adults with femoral neck fracture.Frontiers in nutrition · 2026Article
- Association Between Preoperative Activities of Daily Living and Postoperative Delirium in Elderly Patients Undergoing Non-Cardiac Surgery: A Prospective Cohort Study.Clinical interventions in aging · 2026Article
- Prehabilitation in preparation for surgery.BMJ medicine · 2026Review
- DAGs for dummies: how to extract causation from correlation.British journal of anaesthesia · 2025Article
- The Use of Advanced Glycation End-Product Measurements to Predict Post-Operative Complications After Cardiac Surgery.Journal of clinical medicine · 2025Review
- Directed acyclic graphs to minimise bias and optimise causal inference in SNAP-3: an observational cohort study of frailty, multimorbidity, and delirium in older surgical patients.British journal of anaesthesia · 2025Observational
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOlder surgical patients experience longer hospital stays and a higher risk of morbidity and mortality than their younger counterparts. Frailty (19.6% of cohort) and multimorbidity (63.1% of cohort) increase these risks. The 3
methodsWe conducted a prospective observational cohort study over 5 days in 2022 aiming to recruit all UK patients aged ≥60 yr undergoing surgery (excluding minor procedures). Data included patient characteristics, clinical variables, Clinical Frailty Scale (CFS), multimorbidity (two or more comorbidities), length of stay (LOS), postoperative delirium, morbidity, and mortality. Quantile regression and mixed effects logistic regression were used to analyse relationships.
resultsWe recruited 7129 patients from 214 hospitals. Increasing frailty was associated with longer LOS, higher odds of delirium, morbidity, and mortality ≥1 yr, with a clear increase noted from CFS of 4 (19.0% of cohort). Amongst those without multimorbidity, individuals with CFS score of 4 had longer admissions than non-frail individuals (median LOS 0.75 days longer, 95% confidence interval [CI] 0.34-1.16), increasing to 2.69 days longer for CFS 5 (95% CI 0.76-4.62). Multimorbidity increased the odds of postoperative morbidity by 46% (adjusted odds ratio 1.46, 95% CI 1.24-1.73), but there was no evidence for multimorbidity impacting LOS, delirium, or mortality.
conclusionsSNAP-3 highlights the impact of frailty on postoperative outcomes. Multimorbidity had less impact, with an effect on postoperative morbidity the only one to have strong statistical evidence. The impact of these conditions must be discussed with older patients considering surgical intervention.
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