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Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high\u2010risk procedures undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely to rise as the population ages, this review summarises the evidence on which such guidance is based, and provides information about how anaesthetists might participate in audit and research aimed at improving local and national outcomes for these most vulnerable of patients.<\/jats:p>","DOI":"10.1111\/anae.12492","type":"journal-article","created":{"date-parts":[[2013,12,5]],"date-time":"2013-12-05T04:29:09Z","timestamp":1386217749000},"page":"70-80","source":"Crossref","is-referenced-by-count":58,"title":["Emergency surgery: the big three \u2013 abdominal aortic aneurysm, laparotomy and hip fracture"],"prefix":"10.1111","volume":"69","author":[{"given":"M.","family":"Stoneham","sequence":"first","affiliation":[{"name":"Nuffield Division of Anaesthetics Oxford University Hospitals NHS Trust Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Murray","sequence":"additional","affiliation":[{"name":"James Cook University Hospital Middlesbrough UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N.","family":"Foss","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Hvidovre University Hospital Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,12,5]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"National Confidential Enquiry into Patient Outcome and Death.Extremes of age.1999.http:\/\/www.ncepod.org.uk\/pdf\/1999\/99full.pdf(accessed 30\/09\/2013)."},{"key":"e_1_2_6_3_1","unstructured":"National Confidential Enquiry into Patient Outcome and Death (NCEPOD).Abdominal aortic aneurysm: a service in need of surgery?2005.http:\/\/www.ncepod.org.uk\/2005report2\/Downloads\/AAA_report.pdf(accessed 30\/09\/2013)."},{"key":"e_1_2_6_4_1","unstructured":"National Confidential Enquiry into Patient Outcome and Death.Elective & emergency surgery in the elderly: an age old problem.2010.http:\/\/www.ncepod.org.uk\/2010report3\/downloads\/EESE_fullReport.pdf(accessed 30\/09\/2013)."},{"key":"e_1_2_6_5_1","unstructured":"The Vascular Society of Great Britain and Ireland.National vascular database report.2009.http:\/\/www.vascularsociety.org.uk\/vascular\/wp-content\/uploads\/2012\/11\/NVDREPORTFINAL-10Nov.pdf(accessed 30\/09\/2013)."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes165"},{"key":"e_1_2_6_7_1","unstructured":"National Hip Fracture Database.Annual report.2013.http:\/\/www.nhfd.co.uk\/003\/hipfractureR.nsf\/luMenuDefinitions\/CA920122A244F2ED802579C900553993\/&$file\/NHFD%20Report%202013.pdf?OpenElement(accessed 30\/09\/2013)."},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.232181"},{"key":"e_1_2_6_9_1","unstructured":"National Joint Registry.10th Annual report.2013 149pp.http:\/\/www.njrcentre.org.uk\/njrcentre\/Portals\/0\/Documents\/England\/Reports\/10th_annual_report\/NJR%2010th%20Annual%20Report%202013.pdf(accessed 30\/09\/2013)."},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc4928"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2008.05560.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06769.x"},{"key":"e_1_2_6_13_1","unstructured":"The Royal College of Surgeons of England.Emergency surgery: standards for unscheduled care 2011.http:\/\/www.rcseng.ac.uk\/publications\/docs\/emergency-surgery-standards-for-unscheduled-care\/@@download\/pdffile\/rcs_emergency_surgery_2011_web.pdf(accessed 30\/09\/2013)."},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2011.06957.x"},{"key":"e_1_2_6_15_1","unstructured":"Abdominal Aortic Aneurysm Quality Improvement Programme.Interim report.2011.http:\/\/www.vascularsociety.org.uk\/vascular\/wp-content\/uploads\/2012\/11\/National-AAA-QIP-Interim-Report.pdf(accessed 30\/09\/2013)."},{"key":"e_1_2_6_16_1","unstructured":"GibbonsC KinsmanR WaltonP.The European Society for Vascular Surgery. 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