A5027715269- Cardiac, Anesthesia and Surgical Outcomes
- Hemodynamic Monitoring and Therapy
- Aortic aneurysm repair treatments
- Hip and Femur Fractures
- Frailty in Older Adults
- Cardiovascular and exercise physiology
- Enhanced Recovery After Surgery
- Delphi Technique in Research
- Cardiac Health and Mental Health
- Total Knee Arthroplasty Outcomes
- Clinical practice guidelines implementation
- Cerebrovascular and Carotid Artery Diseases
- Intensive Care Unit Cognitive Disorders
- Aortic Disease and Treatment Approaches
- Cancer survivorship and care
- Anesthesia and Pain Management
- COVID-19 and healthcare impacts
- Obstructive Sleep Apnea Research
- Telemedicine and Telehealth Implementation
- Nutrition and Health in Aging
- Anesthesia and Sedative Agents
- Family and Patient Care in Intensive Care Units
- Advances in Oncology and Radiotherapy
- Airway Management and Intubation Techniques
- Surgical site infection prevention
South Tees Hospitals NHS Foundation Trust
2016-2025
North Yorkshire County Council
2025
James Cook University Hospital
2014-2024
Digital Research Alliance of Canada
2022-2024
Teesside University
2010-2022
Hull York Medical School
2019-2022
Royal Victoria Infirmary
2007-2016
Marymount University
2006-2009
John Hunter Hospital
2001
University of Liverpool
1999
Recently, the number of prehabilitation trials has increased significantly. The identification key research priorities is vital in guiding future directions. Thus, aim this collaborative study was to define for patients undergoing cancer surgery.The Delphi methodology implemented over three rounds surveys distributed experts from across multiple specialties, tumour streams and countries via a secure online platform. In first round, participants were asked provide baseline demographics...
Evidence is limited for the effectiveness of interventions survivors critical illness after hospital discharge. We explored effect an 8-week hospital-based exercise-training programme on physical fitness and quality-of-life.In a parallel-group minimized controlled trial, patients were recruited before discharge or in intensive care follow-up clinic enrolled 8-16 weeks Each week, intervention comprised two sessions physiotherapist-led cycle ergometer exercise (30 min, moderate intensity) plus...
Summary We observed survival after scheduled repair of abdominal aortic aneurysm in 1096 patients for a median ( IQR [range]) 3.0 (1.5–5.8 [0–15]) years: 943 had complete data, 250 whom died. compared discrimination and calibration an external model with the Kaplan–Meier generated from study data. Integrated Brier misclassification scores both models at 1–5 postoperative years were 0.04, 0.08, 0.11, 0.13 0.16, respectively. Harrel's concordance index was 0.73, 0.71, 0.68, 0.67 0.66, Groups...
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....
This study assessed the feasibility of a preoperative high-intensity interval training (HIT) programme in patients awaiting elective abdominal aortic aneurysm repair.In this trial, participants were allocated by minimization to HIT or usual care. Patients group offered three exercise sessions per week for 4 weeks, and weekly maintenance if surgery was delayed. Feasibility acceptability outcomes were: rates screening, eligibility, recruitment, retention, outcome completion, adverse events...
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...
Background The concept of “prehabilitation,” or optimising individual physical and mental wellbeing prior to surgery is well established in cancer orthopaedic populations. However, amongst the cardiac population, relatively new. Of few studies available, all focus on elective surgical population. This pilot feasibility trial novel as it will impact multimodal prehabilitation acute inpatient Methods single centre, prospective, arm recruit 20 inpatients awaiting surgery. Measurements be...
Summary Maintaining safe elective surgical activity during the global coronavirus disease 2019 (COVID‐19) pandemic is challenging and it not clear how COVID‐19 may impact peri‐operative morbidity mortality in this population. Therefore, adaptations to normal care pathways are required. Here, we establish if implementation of a bespoke bundle for urgent surgery surge period can deliver low COVID‐19‐associated complication profile. We present single‐centre retrospective cohort study from...
Summary Patients undergoing major vascular surgery are at high risk of peri‐operative morbidity and mortality owing to a combination advanced age, significant co‐morbidity the nature surgery. A consultant‐led pre‐operative assessment clinic provides an opportunity stratify these patients on basis in advance surgery, make timely multidisciplinary referrals where appropriate, prescribe medical therapies according current best evidence. This results fewer last‐minute cancellations for reasons...
Summary Anaerobic threshold (AT), determined by cardiopulmonary exercise testing (CPET), is a well‐documented measure of pre‐operative fitness, although its reliability in patient populations uncertain. Our aim was to assess the AT measurement patients with abdominal aortic aneurysms. Eighteen were recruited. CPET performed four times over 6‐week period. We examined shifts mean evaluate systematic bias random error assessed using typical within‐patient and intraclass correlation coefficient...
Introduction In patients with large abdominal aortic aneurysm (AAA), open surgical or endovascular repair procedures are often used to minimise the risk of aneurysm-related rupture and death; however, itself carries a high risk. Low cardiopulmonary fitness is associated an increased early post-operative complications death following elective AAA repair. Therefore, should be enhanced before High-intensity interval exercise training (HIT) potent, time-efficient strategy for enhancing fitness....
Patients who survive critical illness often report deterioration in health related quality of life. This has not been shown to improve following post-intensive care unit (ICU) self-directed exercise. The Post Intensive Care eXercise (PIX) study demonstrated improved objectively measured fitness a supervised exercise programme and also suggested beneficial effects on physical mental health. qualitative arm the PIX reported here utilised focus groups explore more detail recovery from illness,...
Following a standardized general anaesthetic for total abdominal hysterectomy, patients received either patient controlled analgesia (PCA) with morphine 1 mg/ml (group M, n = 33) or plus ketamine 2 K, 37) 48 hours in randomized, double-blind fashion. In 43 women the area of allodynia around scar was mapped as measure degree central sensitization. A significant reduction found those receiving (42 cm2 [interquartile range (IQR) 57] compared 57 [IQR 82] z -2.0, P 0.04) alone. There were no...
Purpose: Intervention fidelity refers to the extent an experimental manipulation has been implemented as intended. Our aim was evaluate high-intensity interval training (HIT) in patients awaiting repair of large abdominal aortic aneurysms. Methods: Following a baseline cardiopulmonary exercise test, 27 participants performed hospital-based, supervised HIT intervention four weeks preceding surgery. The thrice weekly on cycle ergometer and involved either 8 × 2-min intervals, each interspersed...