Achten, J

Bretherton, C

Costa, M

Exell, L

BJS Open

English

Queen Mary Research Online

Methods: A systematic electronic search was conducted for studiesreporting oesophagectomy in the elderly population. Meta-analysiswas performed using random-effects modelling to compute odds ratios(OR) and 95% confidence intervals (CI). Primary outcome was overallcomplications and secondary outcomes included anastomotic leaks,cardiac complications, pulmonary complications, overall and disease-free survival. Meta-regression was performed to identify study-, hospi-tal- and patient-level factors confounding study findings.Results: This review included 37 eligible studies involving 61,723patients. Increasing age was significantly associated with increasedrates of overall complications (OR: 1.67, CI 95%: 1.42 – 1.97), cardiaccomplications (OR: 1.62, CI 95%: 1.10 – 2.40), pulmonary complications(OR: 1.44, CI 95%: 1.11 – 1.87) and decreased 5-year overall survival (OR:1.36, CI 95%: 1.11 – 1.66) and 5-year disease-free survival (OR: 1.66, CI95%: 1.40 – 1.97). Rates of anastomotic leaks showed no difference be-tween elderly and younger patients (OR: 1.06, CI 95%: 0.71 – 1.59).Conclusion: Postoperative outcomes such as overall complications, 5-year overall survival and disease-free survival appear to significantlyworse in all age cut-offs in this meta-analysis. Sarcopenia and frailtyact as better predictors of postoperative outcomes than chronologicalage. This study confirms the preconceived suspicions of increased risksin elderly patients following oesophagectomy and will aid future pre-operative counselling and informed consent.P23Associate Principal Investigators in Trauma TrialsChris Bretherton, Lauren Exell, Juul Achten, Matt CostaUniversity of OxfordCorresponding Author: Mr. Chris Bretherton (cpbretherton@gmail.com)Oxford Trauma has designed a collection of randomised clinical trials toanswer important clinical questions in trauma and meaningfully engagetrainees and associate principal investigators (aPI’s) with research.These include:• Children’s Radius Acute Fracture Fixation Trial (CRAFFT):• Weight-Bearing in Ankle Fractures (WAX):• Blood cEll Salvage and autoTransfusion (BEST):• Fractured Ankle Management Evaluation (FAME):• Surgery or Cast for Injuries of the EpicoNdyle in Children’s Elbows(SCIENCE):• The HUmeral SHaft fracture trial (HUSH)Trainee engagement is promoted via:• Registration for the NIHR associate PI scheme with corresponding“how-to guide” for study set-up.• Individually tailored points system for collaborative authorship.• Automatic emailing of certificates for recruitment of participants(For ARCP evidence).• A central database listing trial sites and contacts for aPI’s.https://www.ndorms.ox.ac.uk/Oxford-Trauma-and-Emergency-Care/trainee-involvementThis has led to the recruitment of sites and participants ahead of tar-get, including sites aPI’s have set-up from scratch.We would love for you to join as an aPI or help us refine the model andshare it with other collaborative groups!: Contact Christopher.Bretherton@ndorms.ox.ac.ukP24Audit reviewing viability of removing pre-operative Group andduring the1@NHS.net)healthcare resour-resource should beaudit aims to ascer-to transurethralprostate surgery is necessary and if this resource can be redistributedsafely during the ongoing pandemic.Methods: A retrospective review of electronic patient records forpatients that underwent transurethral prostate surgery from June 2017to June 2018. During a single admission for surgery it was identifiedhow many pre-operative group and save tests, and if a post-operativeblood transfusion patients underwent.Results: 146 patients underwent transurethral prostate surgery be-tween June 2017 to June 2018.97 patients had two valid group and save tests prior to surgery. 49 patientsdid not have 2 valid group and save tests. 21 patients had expired tests, 20had only one valid sample, and 8 had no group and save test at all.No patient underwent a blood transfusion during their admission fortransurethral prostate surgery.Conclusion: This single centre study illustrates pre-operative groupand save tests before transurethral prostate surgery are unnecessary asno patient required an associated blood transfusion during admission;and can safely be omitted. The clinical time and resource could beredirected elsewhere for greater patient benefit. £2855.00 of efficiencysavings could be made foregoing unneeded group and save tests.A policy omitting pre-operative group and save before transurethralprostate surgery will be implemented under COVID19 pandemic condi-tions and re-audited in 6 months.AVNRossRoyalOrthGuidin intofwere••DHS• Co• DisCS, 1oped22%using20% oNotonotioningP26JoycePoster presentation | i7

P23 Associate Principal Investigators in Trauma Trials

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P23 Associate Principal Investigators in Trauma Trials

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