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  1. Article ; Online: Winter cancellations of elective surgical procedures in the UK: a questionnaire survey of patients on the economic and psychological impact.

    Herrod, Philip J J / Adiamah, Alfred / Boyd-Carson, Hannah / Daliya, Prita / El-Sharkawy, Ahmed M / Sarmah, Panchali B / Hossain, Tanvir / Couch, Jennifer / Sian, Tanvir S / Wragg, Andrew / Andrew, David R / Parsons, Simon L / Lobo, Dileep N

    BMJ open

    2019  Volume 9, Issue 9, Page(s) e028753

    Abstract: Objectives: To quantify the economic and psychological impact of the cancellation of operations due to winter pressures on patients, their families and the economy.: Design: This questionnaire study was designed with the help of patient groups. Data ... ...

    Abstract Objectives: To quantify the economic and psychological impact of the cancellation of operations due to winter pressures on patients, their families and the economy.
    Design: This questionnaire study was designed with the help of patient groups. Data were collected on the economic and financial burden of cancellations. Emotions were also quantified on a 5-point Likert scale.
    Setting: Five NHS Hospital Trusts in the East Midlands region of England.
    Participants: We identified 796 participants who had their elective operations cancelled between 1 November 2017 and 31 March 2018 and received responses from 339 (43%) participants.
    Interventions: Participants were posted a modified version of a validated quality of life questionnaire with a prepaid return envelope.
    Main outcome measures: The primary outcome measures were the financial and psychological impact of the cancellation of elective surgery on patients and their families.
    Results: Of the 339 respondents, 163 (48%) were aged <65 years, with 111 (68%) being in employment. Sixty-six (19%) participants had their operations cancelled on the day. Only 69 (62%) of working adults were able to return to work during the time scheduled for their operation, with a mean loss of 5 working days (SD 10). Additional working days were lost subsequently by 60 (54%) participants (mean 7 days (SD 10)). Family members of 111 (33%) participants required additional time off work (mean 5 days (SD 7)). Over 30% of participants reported extreme levels of sadness, disappointment, anger, frustration and stress. At least moderate concern about continued symptoms was reported by 234 (70%) participants, and 193 (59%) participants reported at least moderate concern about their deteriorating condition.
    Conclusions: The cancellation of elective surgery during the winter had an adverse impact on patients and the economy, including days of work lost and health-related anxiety. We recommend better planning, and provision of more notice and better support to patients.
    MeSH term(s) Appointments and Schedules ; Efficiency, Organizational ; Elective Surgical Procedures ; England ; Hospitals, District ; Humans ; Linear Models ; No-Show Patients/psychology ; No-Show Patients/statistics & numerical data ; Operating Rooms/organization & administration ; Seasons ; Surveys and Questionnaires ; Utilization Review ; Workforce
    Language English
    Publishing date 2019-09-13
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2018-028753
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Fasting and surgery timing (FaST) audit.

    El-Sharkawy, Ahmed M / Daliya, Prita / Lewis-Lloyd, Christopher / Adiamah, Alfred / Malcolm, Francesca L / Boyd-Carson, Hannah / Couch, Daniel / Herrod, Philip J J / Hossain, Tanvir / Couch, Jennifer / Sarmah, Panchali B / Sian, Tanvir S / Lobo, Dileep N

    Clinical nutrition (Edinburgh, Scotland)

    2020  Volume 40, Issue 3, Page(s) 1405–1412

    Abstract: Background & aims: International guidance advocates the avoidance of prolonged preoperative fasting due to its negative impact on perioperative hydration. This study aimed to assess the adherence to these guidelines for fasting in patients undergoing ... ...

    Abstract Background & aims: International guidance advocates the avoidance of prolonged preoperative fasting due to its negative impact on perioperative hydration. This study aimed to assess the adherence to these guidelines for fasting in patients undergoing elective and emergency surgery in the East Midlands region of the UK.
    Methods: This prospective audit was performed over a two-month period at five National Health Service (NHS) Trusts across the East Midlands region of the UK. Demographic data, admission and operative details, and length of preoperative fasting were collected on adult patients listed for emergency and elective surgery.
    Results: Of the 343 surgical patients included within the study, 50% (n = 172) were male, 78% (n = 266) had elective surgery and 22% (n = 77) underwent emergency surgery. Overall median fasting times (Q1, Q3) were 16.1 (13.0, 19.4) hours for food and 5.8 (3.5, 10.7) hours for clear fluids. Prolonged fasting >12 h was documented in 73% (n = 250) for food, and 21% (n = 71) for clear fluids. Median fasting times from clear fluids and food were longer in the those undergoing emergency surgery when compared with those undergoing elective surgery: 13.0 (6.4, 22.6) vs. 4.9 (3.3, 7.8) hours, and 22.0 (14.0, 37.4) vs. 15.6 (12.9, 17.8) hours respectively, p < 0.0001.
    Conclusions: Despite international consensus on the duration of preoperative fasting, patients continue to fast from clear fluids and food for prolonged lengths of time. Patients admitted for emergency surgery were more likely to fast for longer than those having elective surgery.
    MeSH term(s) Adult ; Aged ; Clinical Audit ; Dehydration/etiology ; Elective Surgical Procedures ; Emergency Treatment ; Fasting/adverse effects ; Female ; Guideline Adherence ; Humans ; Male ; Middle Aged ; Practice Guidelines as Topic ; Preoperative Care/methods ; Prospective Studies ; Surgical Procedures, Operative/methods ; Time Factors ; United Kingdom
    Language English
    Publishing date 2020-09-05
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2020.08.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Fasting and surgery timing (FaST) audit

    El-Sharkawy, Ahmed M / Daliya, Prita / Lewis-Lloyd, Christopher / Adiamah, Alfred / Malcolm, Francesca L / Boyd-Carson, Hannah / Couch, Daniel / Herrod, Philip J.J / Hossain, Tanvir / Couch, Jennifer / Sarmah, Panchali B / Sian, Tanvir S / Lobo, Dileep N / Anjum, Shahira / Aghanenu, Opusdei / Barlow, Sarah / Chukwuemeka, Wosu / Daud, Hamid / Green, Rebecca /
    King, Michael / Kushairi, Anisa / Moreno-Stokoe, Thomas / Nessa, Ashrafun / Oyende, Olamide / Rashid, Adil / Starkie, Jack / Andrew, David R / Koh, Amanda / Roslan, Farah / Singh, Sona / Thompson, Amari / Busby, Chris / Kotecha, Sita / Latif, Javed / Sargen, Kevin / Herrod, Phillip J.J / Lund, Jonathan N / Pourrie, Jonathan M / Pradhan, Siddhee / Rai, Nanin / Al-Ausi, Muhammed J / Fitzsimonds, Andrew / Ghorpade, Ashwini / Kelkar, Ashish / Wolff, James

    Clinical nutrition. 2020 Aug. 26,

    2020  

    Abstract: International guidance advocates the avoidance of prolonged preoperative fasting due to its negative impact on perioperative hydration. This study aimed to assess the adherence to these guidelines for fasting in patients undergoing elective and emergency ...

    Institution FaST Audit Group
    the East Midlands Surgical Academic Network (EMSAN)
    Abstract International guidance advocates the avoidance of prolonged preoperative fasting due to its negative impact on perioperative hydration. This study aimed to assess the adherence to these guidelines for fasting in patients undergoing elective and emergency surgery in the East Midlands region of the UK.This prospective audit was performed over a two-month period at five National Health Service (NHS) Trusts across the East Midlands region of the UK. Demographic data, admission and operative details, and length of preoperative fasting were collected on adult patients listed for emergency and elective surgery.Of the 343 surgical patients included within the study, 50% (n = 172) were male, 78% (n = 266) had elective surgery and 22% (n = 77) underwent emergency surgery. Overall median fasting times (Q1, Q3) were 16.1 (13.0, 19.4) hours for food and 5.8 (3.5, 10.7) hours for clear fluids. Prolonged fasting >12 h was documented in 73% (n = 250) for food, and 21% (n = 71) for clear fluids. Median fasting times from clear fluids and food were longer in the those undergoing emergency surgery when compared with those undergoing elective surgery: 13.0 (6.4, 22.6) vs. 4.9 (3.3, 7.8) hours, and 22.0 (14.0, 37.4) vs. 15.6 (12.9, 17.8) hours respectively, p < 0.0001.Despite international consensus on the duration of preoperative fasting, patients continue to fast from clear fluids and food for prolonged lengths of time. Patients admitted for emergency surgery were more likely to fast for longer than those having elective surgery.
    Keywords adults ; clinical nutrition ; duration ; fasting ; fluids ; guidelines ; health services ; length ; males ; patients ; surgery
    Language English
    Dates of publication 2020-0826
    Publishing place Elsevier Ltd
    Document type Article
    Note NAL-light ; Pre-press version
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2020.08.033
    Database NAL-Catalogue (AGRICOLA)

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