Improvement of Perioperative Care of Elderly Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 310
- 试验地点
- 1
- 主要终点
- Functional abilities
研究概览
简要总结
The focus of this study is the development of a perioperative treatment concept for elderly patients, based on individual necessities and risk factors, aiming to improve patient outcome. The planned interventions include preoperative screening for malnutrition, frailty and uncalled-for long-term medication, if required followed by early prophylaxis and treatment of these risk factors, prior to or during surgery.
详细描述
In Germany every second inpatient surgical intervention is performed on patients aged 60 years and above. These patients often offer an extensive set of risk factors such as frailty, malnutrition, poor physical fitness and multi-morbidity that may in turn lead to longer hospitalizations and decline of health and functional status after surgery. An age-related increase in postoperative complications, such as postoperative cognitive dysfunction (POCD) and delirium is associated with a higher rate of postoperative morbidity, mortality and longer hospitalization.
Early detection of risk factors and implementation of prophylactic measures is important to reduce postoperative complications and improve clinical outcomes in elderly patients. The aim of our study is to develop and verify a protocol - which allows for a systematic evaluation of risk factors and the implementation of prophylactic or therapeutic measures in order to optimize the postoperative outcome. The feasibility of our protocol will be verified in clinical practice by systematic process evaluations.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Sequential
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age >64 years
- •Written informed patients consent
- •forthcoming elective surgery
- •Time interval from inclusion to appointed surgery at least 5 days
排除标准
- •Refusal of consent
- •Illiteracy
- •Poor knowledge ofGerman language
- •Mental disability
- •Vision handicap (not corrected)
- •Hearing handicap (not corrected)
- •Benzodiazepine abuse
- •Drug/ substance abuse
- •Psychosis
- •Parkinson disease
- •Emergency surgery
- •Planned postoperative ICU treatment
- •Planned inpatient stay 1 night
- •Cerebral surgery
- •Ophthalmological surgery
结局指标
主要结局
Functional abilities
时间窗: Evaluation preoperatively, 1 month, 6 months after surgery
Change in functional abilities from baseline, evaluated by Instrumental Activities of Daily Living (IADL) score
次要结局
- Postoperative complications(Evaluation evaluation of complications at 2-5 days, 1 month, 6 months after surgery)
- Hospital length of stay(1 month)
- Cognitive impairment(Evaluation preoperatively, at 2-5 days, 1 month, 6 months after surgery)
- Attention and task switching(Evaluation preoperatively, at 2-5 days, 1 month, 6 months after surgery)
- Health related quality of life(Evaluation preoperatively, 1 month, 6 months after surgery)
- Attentional capabilities(Evaluation preoperatively, at 2-5 days, 1 month, 6 months after surgery)