A5010570636- Cardiac, Anesthesia and Surgical Outcomes
- Hip and Femur Fractures
- Aortic aneurysm repair treatments
- Hemodynamic Monitoring and Therapy
- Cardiac Health and Mental Health
- Enhanced Recovery After Surgery
- Frailty in Older Adults
- Delphi Technique in Research
- Clinical practice guidelines implementation
- Palliative Care and End-of-Life Issues
- Abdominal Trauma and Injuries
- Childhood Cancer Survivors' Quality of Life
- Abdominal Surgery and Complications
- Emergency and Acute Care Studies
- Trauma and Emergency Care Studies
- Blood Pressure and Hypertension Studies
- Surgical Simulation and Training
- Total Knee Arthroplasty Outcomes
- Cardiovascular and exercise physiology
- Advanced X-ray and CT Imaging
- Telemedicine and Telehealth Implementation
James Cook University Hospital
2013-2024
Northumbria University
2019-2022
South Tees Hospitals NHS Foundation Trust
2014-2022
Hull York Medical School
2022
Teesside University
2022
Health Education North West
2016-2021
Newcastle upon Tyne Hospital
2020
Newcastle University
2018
Pre-operative intervention to improve general health and readiness for surgery is known as prehabilitation. Modification of risk factors such physical inactivity, smoking, hazardous alcohol consumption an unhealthy weight can reduce the peri-operative morbidity patient outcomes. Interventions may need target multiple behaviours. The acceptability patients unclear. We explored motivation, confidence priority changing behaviours before short-term benefits in comparison with long-term benefits....
Recognising frailty during pre-operative assessment is important. Frail patients experience higher mortality rates and are less likely to return baseline functional status following the physiological insult of surgery. We evaluated association between an initial clinical impression all-cause in 392 attending our vascular clinic. Prevalence assessed by was 30.6% (95% CI 26.0-35.2%). There were 133 deaths over a median follow-up period 4 years. Using Cox regression, adjusted for age, sex,...
Optimising health and well-being before elective major surgery via prehabilitation initiatives is important for good postoperative outcomes. In a busy tertiary centre in North East England, the lack of formal service meant that opportunities were being missed to optimise patients surgery. This quality improvement project aimed implement evaluate community-based people awaiting surgery: PREP-WELL. A multidisciplinary, cross-sector team introduced PREP-WELL January 2018. provided comprehensive...
The deployment of physician-led pre-hospital enhanced care teams capable critical interventions at the scene injury may confer a survival benefit to victims major trauma. However, evidence base for this widely adopted model is disputed. Failure identify clear has been attributed several factors, including an inherently more severely injured patient group who are attended by these teams. We undertook novel retrospective analysis impact regional team on observed vs. predicted based outcomes...
Inter-arm differences in blood pressure may confound haemodynamic management vascular surgery. We evaluated 898 patients the pre-assessment clinic to determine prevalence of inter-arm systolic and mean arterial pressure, quantify consequent risk clinical error siting monitoring peri-operatively evaluate difference as a predictor all-cause mortality (median follow-up 49 months). The ≥ 15 mmHg was 26% (95% CI 23-29%). an 10 23-29%) 11% 9-13%) for mmHg. Monitoring could be erroneously sited arm...
Major surgery carries high risks with comorbidities, frailty and health risk behaviours meaning patients are often unprepared for the physiological insult. Since 2018, Prepwell programme at South Tees Hospitals NHS Foundation Trust has supported to improve their preoperative fitness. In April 2020, face-to-face service was suspended due pandemic, leading team implementing a three-tiered remote digital support pathway, including coaching via mobile phone application. Methods Patients...
Improving outcomes for people undergoing major surgery, specifically reducing perioperative morbidity and mortality remains a global health challenge. Prehabilitation involves the active preparation of patients prior to including support tackle risk behaviours that mediate undermine physical mental wellbeing. The majority prehabilitation interventions are delivered in person, however many express preference remotely-delivered provide them with tailored flexibility. Digital offer scalability...
Background Prehabilitation prior to major surgery mandates cross-sector working. Utilising the preoperative window from referral requires clinician engagement. Awareness of perioperative risk factors is crucial. A national survey uncovered gaps in knowledge and understanding. Aim Create an open-access, online educational resource for primary care clinicians. Method Our multidisciplinary team developed a focused CPD targeting lifestyle chronic health conditions influencing (...
Arm-crank ergometry may be useful in patients unable to pedal, for instance due peripheral arterial disease. Twenty participants with small abdominal aortic aneurysm undertook two serial arm-crank tests and then a pedal test, four of whom had indeterminate anaerobic thresholds, precluding analysis. The mean (SD) peak arm leg oxygen consumptions 16 were 13.71 (2.62) ml.kg-1 .min-1 16.82 (4.44) , individual differences 3.11 (2.48) p = 0.0001. respective values at the thresholds 7.83 (1.58) ml...
Abstract Improving outcomes for people undergoing major surgery, specifically reducing perioperative morbidity and mortality remains a global health challenge. Prehabilitation involves the active preparation of patients prior to including support tackle risk behaviours that mediate undermine physical mental wellbeing. The majority prehabilitation interventions are delivered in person, however many express preference remotely-delivered provide them with tailored flexibility. Digital offer...