ELDERLY patients are being tested on exercise bikes - as part of a scheme to assess their fitness before operations.

York District Hospital is achieving some of the best survival rates of pensioners after surgery of any medical centre in the country.

Consultant Dr Jonathan Wilson said all patients over 60 needing major abdominal, upper gastrointestinal or aortic surgery were now asked to go on cardiopulmonary exercise bikes for assessment.

The system has been devised, with support from surgeons, to identify patients most likely to develop serious post-operative problems, which could lead to a prolonged hospital stay or death.

If a patient's risk is high, they are given extra care and monitoring before, during and after their operation, and may be allocated a high-dependency or critical care bed.

If their risk is shown to be extremely high, they might be offered an alternative treatment without surgery, and some patients could be started on medication prior to an operation.

Dr Wilson, who leads the anaesthetists' team, said the aim was to ensure that high-dependency and critical care services, always under pressure, were prioritised to those patients who most needed them. "Our aim is to get as many patients as possible through major surgery safely, but with the minimum impact on scarce resources," he said.

Out of 203 patients who were pre-assessed before undergoing surgery in a year, 19 had been given alternative treatment, while of the remaining 184, only three had died.

This is a fatality rate of less than one-and-a-half per cent, compared with a national average of more than six per cent.

Dr Wilson said the length of hospital stay had also been cut by three days, and the routine use of high dependency and critical care facilities by one third.

York Hospital now has some of the best results in the country for elderly patients undergoing major surgery," he said.

The team's efforts took them to the national finals of a doctor awards scheme, organized by Hospital Doctor magazine. The team narrowly missed out on the title of Anaesthesia Team of the Year.

Updated: 10:33 Wednesday, November 16, 2005