Peri-operative surgical care optimisation for patients requiring emergency surgery (PERI-SCOPES): Protocol for a multicentre mixed-methods study
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Rachel John-Charles1,2, Joanne McPeake3, Carly Bisset2,4
1Department of Surgery, Royal Alexandra Hospital, Paisley, UK.
Introduction:
Emergency General Surgery is a common reason for an emergency admission in the UK with over 25,000 emergency laparotomies (EmLap) performed every year.(1) For frail and co-morbid patients an alternative decision is often made that not undergoing surgery is in their best interest (NoLap). For both EmLap and NoLap patients, little is known about survivorship. This study aims to quantify quality of life (QoL) for EmLap and NoLap patients and explore the decision-making process.
Methods And Analysis:
PERI-SCOPES is a mixed-methods multicentre study exploring QoL and decision-making in Emergency General Surgery. The study will involve two separate workstreams. WORKSTREAM 1: Up to 30 patients, EmLap or NoLap, will be eligible for inclusion and identified by the local research teams. Patients will be recruited from six sites across Scotland. Patients will be invited to nominate a family member/supporter to participate alongside them. Participants will complete validated QoL questionnaires within 4 weeks of EmLap/NoLap decision then again at 3- and 9-12 months post-decision. Questionnaires will include EuroQol five-dimension five-level, Short Form of the Profile of Mood States, International Trauma Questionnaire and Caregiver Strain Index. Patients and their family member/supporter will also take part in three semi-structured interviews at similar time-points to explore their experience of decision-making. WORKSTREAM 2: UK-based consultant decision-makers (surgeons, anaesthetists and intensivists) will be invited to complete an online survey exploring personality, risk-taking and decision-making in Emergency General Surgery. At least 52 consultants will be recruited to ensure sufficient statistical power. Individual semi-structured interviews will be conducted with up to 20 consultants to allow a deeper exploration of decision-making.
Ethics And Dissemination:
PERI-SCOPES is sponsored by The University of Glasgow and has received ethical approval from East of Scotland REC (25/ES/0015). This study has Research and Innovation (R&I) approval from NHS Greater Glasgow and Clyde, Grampian, Tayside and Lothian (6 hospital sites). We aim to disseminate results via peer-reviewed medical journals and conferences.
Trials Registration Number:
NCT06972017.
