SNAP3 Study

Principal Investigator
Tom Poulton

Project Details

Sprint National Anaesthesia Project 3 (SNAP 3)

There is a continuing global increase in number of older people undergoing surgery. As the body ages its physiological reserves decline, which can result in an increased vulnerability to acute stressors, such as the process of undergoing and recovering from surgery. This increased vulnerability is known as frailty.

Rates of multimorbidity and frailty increase with age, and delirium is a key perioperative organ dysfunction in older patients. The relationships between these separate clinical entities are complex and are not fully understood. Understanding their epidemiology in the perioperative setting is key to improving the perioperative care provided for older patients. Evaluating the current assessment and management of these conditions will provide insight into the optimal provision of perioperative care and risk stratification for this growing cohort of patients.

The study aims to describe the epidemiology and impact of frailty, multimorbidity, and delirium in 12,000 people ≥60 years old, undergoing surgery in the UK, Australia, and New Zealand.

The study will:

Examine the roles of frailty, delirium, and multimorbidity in predicting perioperative outcomes.
Describe the variations in frailty- and delirium-related assessments and interventions.
Identify associations between frailty-related interventions and outcome.

It is hoped these findings will inform evidence-based practice to most effectively distribute resources and allow us to understand what constitutes excellent care for older people having surgery.

Completion of Study;

The SNAP 3 Project was completed in November 2023.

Our target Recruitment for the Australian Arm was 1200, the actual recruitment total was 1894. This was possible through engagement and coordination with more than 20s sites across Australia. This project has demonstrated that it is feasible to undertake "sprint" style observational research in an Australian context and that there is a willingness for medical staff to become involved at various levels (medical student to consultant) at various sites across the country. However, there are significant regulatory and administrative hurdles, so there would be benefit from a national body that is familiar with the processes and could support this work in future to save investigators having to re-learn the lessons each time.