{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:11:36Z","timestamp":1785391896733,"version":"3.55.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Patients with chronic limb-threatening ischaemia (CLTI) are often admitted emergently with significant comorbidity and frailty, and little time for pre-optimisation, resulting in longer hospital stays and worse outcomes. Our unit implemented a POPS (Perioperative Medicine for the Older Person undergoing Surgery) service, incorporating the comprehensive geriatric assessment (CGA) to optimise patients. This study assesses its effect on non-elective CLTI inpatients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a prospective observational cohort study at a single vascular centre, analysing outcomes in non-elective CLTI patients over three different periods: one year prior to POPS (\u2018Pre-POPS\u2019); during the initial delivery when it was nurse-led (\u2018POPS v1\u2019); and after it became physician-led (\u2018POPS v2\u2019). The primary outcome was length of stay (LoS), with 30-day and 12-month secondary outcomes. Cohorts were compared using propensity-score weighted statistical analysis. Economic analysis was undertaken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six hundred and two patients were included. LoS reduced sequentially with greater POPS input (17\u00a0days vs. 13\u00a0days vs. 11\u00a0days, P\u00a0&amp;lt;\u2009.001). There was a significant reduction in 30-day acute kidney injury (33% vs. 37% vs. 8%, P\u00a0&amp;lt;\u2009.001), myocardial infarction (15% vs. 2% vs. 2% P\u00a0&amp;lt;\u2009.001) and hospital-acquired pneumonia (17% vs. 10% vs. 9%, P\u00a0=\u2009.048). Cox survival regression found a reduction in 12-month mortality of 37% for the POPS v1 [HR 0.628 (95% CI 0.481\u20130.891) P\u00a0=\u2009.013] and 40% for the POPS v2 [HR 0.598 (95% CI 0.431\u20130.913) P\u00a0=\u2009.001] cohorts, respectively. Economic analysis found that handling more medically complex patients with a shorter LoS negated its operational costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A Vascular-POPS collaborative service has resulted in major improvements in LoS, adverse events and survival in this most vulnerable of vascular patient cohorts and is a financially sustainable initiative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag003","type":"journal-article","created":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T12:32:58Z","timestamp":1768134778000},"source":"Crossref","is-referenced-by-count":2,"title":["Vascular-POPS: evidence for a new standard of care in the management of chronic limb-threatening Ischaemia"],"prefix":"10.1093","volume":"55","author":[{"given":"Assad","family":"Khan","sequence":"first","affiliation":[{"name":"Leeds General Infirmary , Great George Street, Leeds LS1 3EX ,","place":["UK"]},{"name":"Faculty of Medicine and Health, University of Leeds , Woodhouse, Leeds LS2 9JT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8341-3585","authenticated-orcid":false,"given":"Henry","family":"Davies","sequence":"additional","affiliation":[{"name":"Leeds General Infirmary , Great George Street, Leeds LS1 3EX ,","place":["UK"]},{"name":"Faculty of Medicine and Health, University of Leeds , Woodhouse, Leeds LS2 9JT ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee-Ellen","family":"Fawcett","sequence":"additional","affiliation":[{"name":"Leeds General Infirmary , Great George Street, Leeds LS1 3EX ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosie","family":"Darwood","sequence":"additional","affiliation":[{"name":"Leeds General Infirmary , Great George Street, Leeds LS1 3EX 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