Outcomes Following Major Surgery in Older AdultsIPOSNCT07895199
The Irish Perioperative OutcomeS (IPOS) Study
An observational study of Outcomes Following Major Surgery in Older Adults, run by University College Hospital Galway.
Trial summary
The Irish Perioperative OutcomeS (IPOS) Study aims to better understand the factors that influence recovery and outcomes in older adults undergoing major surgery in Ireland. As people live longer and more individuals have multiple long-term health conditions, increasing numbers of older patients require surgical… Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Outcomes Following Major Surgery in Older Adults
- How many people
- 500 participants
- Where
- No sites listed yet
- Study dates
- 2 Nov 2026to 31 Dec 2027
- How long will I take part?
- 7 Days
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Adults aged 60 years and older undergoing major elective or emergency inpatient surgery at participating hospitals in Ireland during the study recruitment period. Eligible participants will include patients admitted for major surgical procedures requiring postoperative hospital care. Patients undergoing day-case procedures, cardiac surgery, neurosurgery, obstetric procedures, or radiological interventions will be excluded in accordance with the study protocol. Participants will be observed prospectively to assess perioperative risk factors, postoperative complications, healthcare resource utilization, and clinical outcomes.
Who may be able to join
- Patients ≥60 years
- Emergency surgery (category I, category II or category III) AND/OR Intermediate to Major elective surgery
- Patient requires an inpatient postoperative stay.
- ASA grade 2 - 5 (2E to 5E)
Who cannot join
- Patients undergoing planned day-case surgery
- Patients undergoing cardiac surgery, neurosurgery, or radiological or obstetric procedures.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
Celia Thomas contact
About this study
Official title: Understanding The Factors Contributing To Perioperative Morbidity In Older Perioperative Patients In Ireland: The Irish Perioperative Outcomes (IPOS) Study
The Irish Perioperative OutcomeS (IPOS) Study aims to better understand the factors that influence recovery and outcomes in older adults undergoing major surgery in Ireland. As people live longer and more individuals have multiple long-term health conditions, increasing numbers of older patients require surgical treatment. These patients may be at greater risk of complications after surgery, including infections, heart problems, delirium (confusion), admission to intensive care, and death.
This study will collect information from routine medical records of patients aged 60 years and older who undergo major planned or emergency surgery in participating hospitals across Ireland. No changes will be made to patients' treatment or care, and no additional tests or procedures will be performed as part of the study.
Read more
Researchers will examine patient characteristics, health conditions, frailty, surgical factors, postoperative complications, and the level of care patients receive after surgery. The study will also evaluate whether access to critical care services and other healthcare resources affects outcomes.
The information gathered will help identify factors associated with better and worse surgical outcomes and may highlight opportunities to improve perioperative care for older patients. Findings from the study are expected to support healthcare planning, resource allocation, and quality improvement initiatives aimed at improving the safety and outcomes of surgery for older adults in Ireland.
Read the detailed description
The Irish Perioperative OutcomeS (IPOS) Study is a national, multicentre, prospective observational cohort study designed to characterize perioperative risk, resource utilization, and clinical outcomes among older adults undergoing major inpatient surgery in Ireland.
Advances in perioperative medicine and surgical techniques have enabled increasing numbers of older patients with multiple comorbidities to undergo complex surgical procedures. However, older surgical patients remain at increased risk of postoperative complications, including pneumonia, sepsis, cardiac events, delirium, unplanned intensive care unit (ICU) admission, and mortality. Despite international evidence describing these risks, there is limited contemporary national data regarding perioperative risk profiles, adverse outcomes, and healthcare capacity within the Irish healthcare system.
The IPOS Study will recruit consecutive eligible patients aged 60 years and older undergoing major elective surgery requiring hospital admission or emergency surgery at participating hospitals throughout Ireland. Patients undergoing planned day-case procedures, cardiac surgery, neurosurgery, obstetric procedures, or radiological interventions will be excluded.
This is a non-interventional study. Data will be collected prospectively from routinely recorded clinical information during a 14-day enrollment period at each participating site. No study-specific interventions, investigations, or alterations to clinical care will occur.
Data collected will include:
Demographic and clinical characteristics. Comorbidities, frailty status, and cognitive status. Surgical urgency and procedure characteristics. Perioperative clinical variables. Planned and actual postoperative care location. Postoperative morbidity and complications. Delirium status. Unplanned ICU admissions. Need for additional surgical procedures. In-hospital outcomes, including mortality.
The primary objective is to assess the complexity and risk profile of older adults presenting for major surgery in Ireland. Secondary objectives include determining the incidence of major perioperative adverse outcomes, evaluating unmet needs in postoperative care provision, and identifying potentially modifiable patient-related, treatment-related, and system-related factors associated with adverse outcomes.
Approximately 500 participants will be enrolled across multiple Irish hospitals. Study findings will provide important evidence regarding perioperative care delivery and outcomes in Ireland and may inform future healthcare policy, service planning, resource allocation, and quality improvement initiatives for high-risk surgical patients.
- Keywords
- Older adults, Major surgery, Perioperative medicine, Geriatric surgery, Critical care, Resource utilization, Ireland
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Older Adults Undergoing Major Surgery | Adults aged 60 years and older undergoing major elective or emergency inpatient surgery at participating hospitals in Ireland. Participants are observed prospectively during their hospital admission to evaluate perioperative characteristics, postoperative complications, critical care requirements, and clinical outcomes. No study-specific interventions are administered, and all care is provided according to standard clinical practice. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Major Postoperative Complications
Incidence of major postoperative complications within 7 days of surgery, defined as a Postoperative Morbidity Survey (POMS) score greater than 1.
Measured: Within 7 days of surgery
Secondary outcomes (6)
Major Perioperative Adverse Outcomes by Organ System
Incidence of major perioperative adverse outcomes categorized by organ system.
Measured: Within 7 days of surgery or until hospital discharge, whichever occurs first
All-Cause In-Hospital Mortality
All-cause in-hospital mortality occurring by Day 7 following surgery or hospital discharge if earlier.
Measured: Day 7 after surgery or hospital discharge, whichever occurs first
Unplanned Critical Care Admission
Need for unplanned admission to an Intensive Care Unit (ICU), High Dependency Unit (HDU), or Post-Anesthesia Care Unit (PACU).
Measured: Within 7 days of surgery
Postoperative Delirium
Incidence of postoperative delirium assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) or the 4 'A's Test (4AT), depending on the patient's level of care.
Measured: Within 7 days of surgery
Time From Decision for Surgery to Induction of Anaesthesia
Time interval between the clinical decision for urgent or emergency surgery and induction of anaesthesia.
Measured: Perioperative period
Unmet Need for Postoperative Critical Care
Percentage of requests for postoperative ICU, HDU, or PACU care that are not provided.
Measured: During the index hospital admission
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 Oct 2026
- Study start2 Nov 2026 (estimated)
- Primary completion28 Feb 2027 (estimated)
- Study completion31 Dec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Outcomes Following Major Surgery in Older AdultsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 500 participants (estimated)
- Target duration
- 7 Days
Sponsor and investigators
- Lead sponsor
- University College Hospital Galway
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, John Laffey, University College Hospital Galway
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07895199
- Sponsor's protocol ID
- C.A.3540
- Acronym
- IPOS
- Status last verified
- Oct 2026
- First submitted
- 19 Oct 2026
- Last updated
- 26 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Swarbrick CJ; SNAP-3 collaborators; Williams K, Evans B, Blake HA, Poulton T, Nava S, Shah A, Martin P, Partridge JSL, Moppett IK. Postoperative outcomes in older patients living with frailty and multimorbidity in the UK: SNAP-3, a snapshot observational study. Br J Anaesth. 2025 Jul;135(1):166-176. doi: 10.1016/j.bja.2025.04.026. Epub 2025 May 27.
PubMed 40425395Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology. Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65. doi: 10.1016/S0140-6736(12)61148-9.
PubMed 22998715International Surgical Outcomes Study group. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016 Oct 31;117(5):601-609. doi: 10.1093/bja/aew316.
PubMed 27799174Abbott TEF, Fowler AJ, Dobbs TD, Harrison EM, Gillies MA, Pearse RM. Frequency of surgical treatment and related hospital procedures in the UK: a national ecological study using hospital episode statistics. Br J Anaesth. 2017 Aug 1;119(2):249-257. doi: 10.1093/bja/aex137.
PubMed 28854546Pearse RM, Harrison DA, James P, Watson D, Hinds C, Rhodes A, Grounds RM, Bennett ED. Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit Care. 2006;10(3):R81. doi: 10.1186/cc4928. Epub 2006 Jun 2.
PubMed 16749940
Study at a glance
From the registry record, last updated by the sponsor on 26 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Understanding The Factors Contributing To Perioperative Morbidity In Older Perioperative Patients In Ireland: The Irish Perioperative Outcomes (IPOS) Study
- ClinicalTrials.gov ID
- NCT07895199
- Acronym / sponsor ID
- IPOS / C.A.3540
- Keywords
- Older adults, Major surgery, Perioperative medicine, Geriatric surgery, Critical care, Resource utilization, Ireland
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 500 participants (estimated)
- Lead sponsor
- University College Hospital GalwayUniversity, hospital or other
- Study start
- 2 Nov 2026 (estimated)
- Primary completion
- 28 Feb 2027 (estimated)
- Study completion
- 31 Dec 2027 (estimated)
- First posted
- 26 Oct 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The Irish Perioperative OutcomeS (IPOS) Study aims to better understand the factors that influence recovery and outcomes in older adults undergoing major surgery in Ireland. As people live longer and more individuals have multiple long-term health conditions, increasing numbers of older patients require surgical treatment. These patients may be at greater risk of complications after surgery, including infections, heart problems, delirium (confusion), admission to intensive care, and death.
This study will collect information from routine medical records of patients aged 60 years and older who undergo major planned or emergency surgery in participating hospitals across Ireland. No changes will be made to patients' treatment or care, and no additional tests or procedures will be performed as part of the study.
Researchers will examine patient characteristics, health conditions, frailty, surgical factors, postoperative complications, and the level of care patients receive after surgery. The study will also evaluate whether access to critical care services and other healthcare resources affects outcomes.
The information gathered will help identify factors associated with better and worse surgical outcomes and may highlight opportunities to improve perioperative care for older patients. Findings from the study are expected to support healthcare planning, resource allocation, and quality improvement initiatives aimed at improving the safety and outcomes of surgery for older adults in Ireland.
Detailed description
The Irish Perioperative OutcomeS (IPOS) Study is a national, multicentre, prospective observational cohort study designed to characterize perioperative risk, resource utilization, and clinical outcomes among older adults undergoing major inpatient surgery in Ireland.
Advances in perioperative medicine and surgical techniques have enabled increasing numbers of older patients with multiple comorbidities to undergo complex surgical procedures. However, older surgical patients remain at increased risk of postoperative complications, including pneumonia, sepsis, cardiac events, delirium, unplanned intensive care unit (ICU) admission, and mortality. Despite international evidence describing these risks, there is limited contemporary national data regarding perioperative risk profiles, adverse outcomes, and healthcare capacity within the Irish healthcare system.
The IPOS Study will recruit consecutive eligible patients aged 60 years and older undergoing major elective surgery requiring hospital admission or emergency surgery at participating hospitals throughout Ireland. Patients undergoing planned day-case procedures, cardiac surgery, neurosurgery, obstetric procedures, or radiological interventions will be excluded.
This is a non-interventional study. Data will be collected prospectively from routinely recorded clinical information during a 14-day enrollment period at each participating site. No study-specific interventions, investigations, or alterations to clinical care will occur.
Data collected will include:
Demographic and clinical characteristics. Comorbidities, frailty status, and cognitive status. Surgical urgency and procedure characteristics. Perioperative clinical variables. Planned and actual postoperative care location. Postoperative morbidity and complications. Delirium status. Unplanned ICU admissions. Need for additional surgical procedures. In-hospital outcomes, including mortality.
The primary objective is to assess the complexity and risk profile of older adults presenting for major surgery in Ireland. Secondary objectives include determining the incidence of major perioperative adverse outcomes, evaluating unmet needs in postoperative care provision, and identifying potentially modifiable patient-related, treatment-related, and system-related factors associated with adverse outcomes.
Approximately 500 participants will be enrolled across multiple Irish hospitals. Study findings will provide important evidence regarding perioperative care delivery and outcomes in Ireland and may inform future healthcare policy, service planning, resource allocation, and quality improvement initiatives for high-risk surgical patients.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 7 Days
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Older Adults Undergoing Major Surgery | – | –Adults aged 60 years and older undergoing major elective or emergency inpatient surgery at participating hospitals in Ireland. Participants are observed prospectively during their hospital admission to evaluate perioperative characteristics, postoperative complications, critical care requirements, and clinical outcomes. No study-specific interventions are administered, and all care is provided according to standard clinical practice. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Adults aged 60 years and older undergoing major elective or emergency inpatient surgery at participating hospitals in Ireland during the study recruitment period. Eligible participants will include patients admitted for major surgical procedures requiring postoperative hospital care. Patients undergoing day-case procedures, cardiac surgery, neurosurgery, obstetric procedures, or radiological interventions will be excluded in accordance with the study protocol. Participants will be observed prospectively to assess perioperative risk factors, postoperative complications, healthcare resource utilization, and clinical outcomes.
Key inclusion criteria (4 listed)
- Patients ≥60 years
- Emergency surgery (category I, category II or category III) AND/OR Intermediate to Major elective surgery
- Patient requires an inpatient postoperative stay.
- ASA grade 2 - 5 (2E to 5E)
Key exclusion criteria (2 listed)
- Patients undergoing planned day-case surgery
- Patients undergoing cardiac surgery, neurosurgery, or radiological or obstetric procedures.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Major Postoperative Complications
Time frame: Within 7 days of surgery
Incidence of major postoperative complications within 7 days of surgery, defined as a Postoperative Morbidity Survey (POMS) score greater than 1.
6 secondary outcomes
Major Perioperative Adverse Outcomes by Organ System
Time frame: Within 7 days of surgery or until hospital discharge, whichever occurs first
All-Cause In-Hospital Mortality
Time frame: Day 7 after surgery or hospital discharge, whichever occurs first
Unplanned Critical Care Admission
Time frame: Within 7 days of surgery
Postoperative Delirium
Time frame: Within 7 days of surgery
Time From Decision for Surgery to Induction of Anaesthesia
Time frame: Perioperative period
Unmet Need for Postoperative Critical Care
Time frame: During the index hospital admission
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Oct 2026.
- Background: PubMed 40425395Swarbrick CJ; SNAP-3 collaborators; Williams K, Evans B, Blake HA, Poulton T, Nava S, Shah A, Martin P, Partridge JSL, Moppett IK. Postoperative outcomes in older patients living with frailty and multimorbidity in the UK: SNAP-3, a snapshot observational study. Br J Anaesth. 2025 Jul;135(1):166-176. doi: 10.1016/j.bja.2025.04.026. Epub 2025 May 27.
- Background: PubMed 22998715Pearse RM, Moreno RP, Bauer P, Pelosi P, Metnitz P, Spies C, Vallet B, Vincent JL, Hoeft A, Rhodes A; European Surgical Outcomes Study (EuSOS) group for the Trials groups of the European Society of Intensive Care Medicine and the European Society of Anaesthesiology. Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012 Sep 22;380(9847):1059-65. doi: 10.1016/S0140-6736(12)61148-9.
- Background: PubMed 27799174International Surgical Outcomes Study group. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016 Oct 31;117(5):601-609. doi: 10.1093/bja/aew316.
- Background: PubMed 28854546Abbott TEF, Fowler AJ, Dobbs TD, Harrison EM, Gillies MA, Pearse RM. Frequency of surgical treatment and related hospital procedures in the UK: a national ecological study using hospital episode statistics. Br J Anaesth. 2017 Aug 1;119(2):249-257. doi: 10.1093/bja/aex137.
- Background: PubMed 16749940Pearse RM, Harrison DA, James P, Watson D, Hinds C, Rhodes A, Grounds RM, Bennett ED. Identification and characterisation of the high-risk surgical population in the United Kingdom. Crit Care. 2006;10(3):R81. doi: 10.1186/cc4928. Epub 2006 Jun 2.
- Individual participant dataSharing planned: Undecided
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Celia Thomas contact
Questions about this trial
What is this clinical trial studying?
An observational study of Outcomes Following Major Surgery in Older Adults, run by University College Hospital Galway.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 26 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact John Laffey (+353 91898375, jlaffey@universityofgalway.ie), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Major Postoperative Complications (time frame: Within 7 days of surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07895199, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2026.