Estimating the effect of frailty on longer-term survival following emergency laparotomy: an observational study using National Emergency Laparotomy Audit data.

Introduction: Approximately 30,000 emergency laparotomies are performed each year across the UK. Over half are in patients aged ≥ 65 y, with a third of this group living with frailty. The association between frailty and 90-day mortality following surgery is well documented, but the longer-term mortality risk has been studied less extensively, despite clear implications for person-centred care.

Recognising, reducing and preventing deconditioning in hospitalised older people.

Deconditioning is caused by complex physiological changes occurring as a result of immobility, for example during or after a period of acute illness or injury and hospitalisation. It leads to functional decline and compounds or contributes to conditions such as frailty and sarcopenia. In the past, prolonged bed rest was considered therapeutic, but the need to reduce or avoid prolonged immobility is now widely recognised.

Understanding the issues experienced by older people undergoing emergency surgery.

The number of older people undergoing surgery in the UK is increasing, partly due to an ageing population and advances in surgical techniques. However, outcomes for older patients who have undergone surgery are suboptimal when compared with younger people, especially following emergency surgery. To minimise the risk of adverse events affecting older people following surgery, it is essential that nurses understand how to manage common challenges for this patient group such as delirium, pain, reduced mobility and inadequate hydration.

Multiple house occupancy is associated with mortality in hospitalized patients with COVID-19.

Background: In response to the COVID-19 pandemic, many countries mandated staying at home to reduce transmission. This study examined the association between living arrangements (house occupancy numbers) and outcomes in COVID-19.

Methods: Study population was drawn from the COPE study, a multicentre cohort study.

Routine use of immunosuppressants is associated with mortality in hospitalised patients with COVID-19.

Background: Whilst there is literature on the impact of SARS viruses in the severely immunosuppressed, less is known about the link between routine immunosuppressant use and outcome in COVID-19. Consequently, guidelines on their use vary depending on specific patient populations.

Methods: The study population was drawn from the COPE Study (COVID-19 in Older People), a multicentre observational cohort study, across the UK and Italy.

The influence of ACE inhibitors and ARBs on hospital length of stay and survival in people with COVID-19.

Objective: During the COVID-19 pandemic the continuation or cessation of angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) has been contentious. Mechanisms have been proposed for both beneficial and detrimental effects. Recent studies have focused on mortality with no literature having examined length of hospital stay.

Study protocol for the COPE study: COVID-19 in Older PEople: the influence of frailty and multimorbidity on survival. A multicentre, European observational study.

Introduction: This protocol describes an observational study which set out to assess whether frailty and/or multimorbidity correlates with short-term and medium-term outcomes in patients diagnosed with COVID-19 in a European, multicentre setting.

Methods And Analysis: Over a 3-month period we aim to recruit a minimum of 500 patients across 10 hospital sites, collecting baseline data including: patient demographics; presence of comorbidities; relevant blood tests on admission; prescription of ACE inhibitors/angiotensin receptor blockers/non-steroidal anti-inflammatory drugs/immunosuppressants; smoking status; Clinical Frailty Score (CFS); length of hospital stay; mortality and readmission. All patients receiving inpatient hospital care >18 years who receive a diagnosis of COVID-19 are eligible for inclusion.

Prior Routine Use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Important Outcomes in Hospitalised Patients with COVID-19.

Coronavirus disease 2019 (COVID-19) infection causes acute lung injury, resulting from aggressive inflammation initiated by viral replication. There has been much speculation about the potential role of non-steroidal inflammatory drugs (NSAIDs), which increase the expression of angiotensin-converting enzyme 2 (ACE2), a binding target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to enter the host cell, which could lead to poorer outcomes in COVID-19 disease. The aim of this study was to examine the association between routine use of NSAIDs and outcomes in hospitalised patients with COVID-19.

The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study.

Background: The COVID-19 pandemic has placed unprecedented strain on health-care systems. Frailty is being used in clinical decision making for patients with COVID-19, yet the prevalence and effect of frailty in people with COVID-19 is not known. In the COVID-19 in Older PEople (COPE) study we aimed to establish the prevalence of frailty in patients with COVID-19 who were admitted to hospital and investigate its association with mortality and duration of hospital stay.

Emergency laparotomy in the older patient: factors predictive of 12-month mortality-Salford-POPS-GS. An observational study.

Introduction: Although high rates of in-hospital mortality have been described in older patients undergoing emergency laparotomy (EL), less is known about longer-term outcomes in this population. We describe factors present at the time of hospital admission that influence 12-month survival in older patients.

Methods: Observational study of patients aged 75 years and over, who underwent EL at our hospital between 8th September 2014 and 30th March 2017.

Specialist nurses improve outcomes in heart failure.

There are growing numbers of heart failure specialist nurses, who are well placed to act as a point of contact for patients with chronic heart failure in acute and primary care settings. Analysis of four studies shows that the work of these nurses improves quality of life and reduces hospital admissions. However, fewer than half of the patients who could benefit from referral to a heart failure nurse are actually referred, and there is a need for health professionals to be educated about their role.