Understanding the impact of multimorbidity and polypharmacy on outcomes for patients undergoing major surgery
Supervisors:
Dr Annemarie Docherty, Usher Institute (University of Edinburgh)
Prof Ewen Harrison, Centre for Medical Informatics, Usher Institute (University of Edinburgh)
Dr Rosalyn Pearson, Usher Institute (University of Edinburgh)
Dr Craig Nicolson, Centre for Medical Informatics, Usher Institute (University of Edinburgh)
Summary:
With an ageing population and rising rates of long-term conditions, one in eight patients undergoing major surgery in the UK now lives with multimorbidity. These patients often take multiple medications, polypharmacy, which may independently increase surgical risk by affecting drug metabolism, increasing adverse drug interactions, and reducing tolerance to intra-operative stress.
This PhD project will explore how multimorbidity and polypharmacy interact with peri-operative haemodynamic instability (such as low blood pressure or oxygen delivery) to influence serious complications including delirium, acute kidney injury (AKI), cardiovascular events, and mortality. It will also examine how variation in medication management practices, such as stopping or continuing drugs before surgery, affects outcomes.
Using large, linked NHS datasets including prescribing records, physiological monitoring data, and hospital outcomes, this research will identify high-risk patient groups, uncover potentially modifiable risk factors, and support the development of evidence-based peri-operative strategies.
This is a unique opportunity to improve care for a growing, high-risk surgical population and to influence national guidance on peri-operative management in patients with complex health needs.
We will offer the student training in epidemiology, causal inference, and machine learning clustering techniques.